Provider Demographics
NPI:1457682668
Name:SAWKAR MEDICAL CORPORATION
Entity Type:Organization
Organization Name:SAWKAR MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:UJVALA
Authorized Official - Middle Name:A
Authorized Official - Last Name:SAWKAR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:619-470-4175
Mailing Address - Street 1:1633 ERRINGER RD
Mailing Address - Street 2:1ST FLOOR
Mailing Address - City:SIMI VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:93065-3557
Mailing Address - Country:US
Mailing Address - Phone:805-578-8300
Mailing Address - Fax:805-578-3911
Practice Address - Street 1:1633 ERRINGER RD
Practice Address - Street 2:1ST FLOOR
Practice Address - City:SIMI VALLEY
Practice Address - State:CA
Practice Address - Zip Code:93065-3557
Practice Address - Country:US
Practice Address - Phone:805-578-8300
Practice Address - Fax:805-578-3911
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAC42334207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical PathologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A452000Medicaid
CA00A452000Medicaid