Provider Demographics
NPI:1063448389
Name:SAGGAR, KAVITA (PA)
Entity Type:Individual
Prefix:
First Name:KAVITA
Middle Name:
Last Name:SAGGAR
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:KAVITA
Other - Middle Name:
Other - Last Name:CHABRA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:1641 E OSBORN RD
Mailing Address - Street 2:STE 4
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85016-7146
Mailing Address - Country:US
Mailing Address - Phone:480-630-2886
Mailing Address - Fax:480-378-8124
Practice Address - Street 1:1641 E OSBORN RD STE 4
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85016-7146
Practice Address - Country:US
Practice Address - Phone:480-630-2886
Practice Address - Fax:480-378-8124
Is Sole Proprietor?:No
Enumeration Date:2006-06-26
Last Update Date:2022-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA15109363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WPA15109AMedicare ID - Type Unspecified
CAP34685Medicare UPIN