Provider Demographics
NPI:1649234980
Name:PARAGON HEALTH, P.C.
Entity Type:Organization
Organization Name:PARAGON HEALTH, P.C.
Other - Org Name:PARK ALLERGY CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:SANJAY
Authorized Official - Middle Name:P
Authorized Official - Last Name:DALAL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:269-341-4554
Mailing Address - Street 1:430 W CENTRE AVE
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49024-5304
Mailing Address - Country:US
Mailing Address - Phone:269-321-6673
Mailing Address - Fax:269-324-5594
Practice Address - Street 1:430 W CENTRE AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-5304
Practice Address - Country:US
Practice Address - Phone:269-321-6673
Practice Address - Fax:269-324-5594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-13
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI207K00000X, 207KA0200X, 207KI0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergyGroup - Multi-Specialty
No207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
No207KI0005XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyClinical & Laboratory ImmunologyGroup - Multi-Specialty