Provider Demographics
NPI:1639852395
Name:SIGSUG HEALTHCARE PC
Entity Type:Organization
Organization Name:SIGSUG HEALTHCARE PC
Other - Org Name:SIGSUG HEALTHCARE PC
Other - Org Type:Other Name
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:FARAH
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:310-879-7167
Mailing Address - Street 1:8200 WILSHIRE BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90211-2321
Mailing Address - Country:US
Mailing Address - Phone:310-933-5688
Mailing Address - Fax:
Practice Address - Street 1:38221 PLYMOUTH RD STE 27
Practice Address - Street 2:
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48150-1051
Practice Address - Country:US
Practice Address - Phone:310-933-5688
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-09
Last Update Date:2023-08-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty