Provider Demographics
NPI:1891259420
Name:UGRADAR, SOHEAB (MD)
Entity Type:Individual
Prefix:DR
First Name:SOHEAB
Middle Name:
Last Name:UGRADAR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9675 BRIGHTON WAY STE 410
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-5192
Mailing Address - Country:US
Mailing Address - Phone:310-363-8757
Mailing Address - Fax:
Practice Address - Street 1:300 STEIN PLAZA
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-0001
Practice Address - Country:US
Practice Address - Phone:310-206-8250
Practice Address - Fax:310-825-9263
Is Sole Proprietor?:No
Enumeration Date:2019-01-28
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA186849207WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery