Provider Demographics
NPI:1073764643
Name:UCSL LLC
Entity Type:Organization
Organization Name:UCSL LLC
Other - Org Name:DUC INTERNAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:DR
Authorized Official - First Name:SONNY
Authorized Official - Middle Name:S
Authorized Official - Last Name:SAGGAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-323-8823
Mailing Address - Street 1:916 OLIVE ST
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63101-1459
Mailing Address - Country:US
Mailing Address - Phone:314-323-8823
Mailing Address - Fax:
Practice Address - Street 1:916 OLIVE ST
Practice Address - Street 2:SUITE 2
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63101-1459
Practice Address - Country:US
Practice Address - Phone:314-323-8823
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-10-01
Last Update Date:2008-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2000160387207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty