Provider Demographics
NPI:1922327584
Name:DUGAR, DEEPAK RAJ (MD)
Entity Type:Individual
Prefix:
First Name:DEEPAK
Middle Name:RAJ
Last Name:DUGAR
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 1:414 N CAMDEN DR STE 801
Mailing Address - Street 2:
Mailing Address - City:BEVERLY HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:90210-4524
Mailing Address - Country:US
Mailing Address - Phone:310-276-1703
Mailing Address - Fax:
Practice Address - Street 1:414 N CAMDEN DR STE 801
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90210-4524
Practice Address - Country:US
Practice Address - Phone:310-276-1703
Practice Address - Fax:310-276-5501
Is Sole Proprietor?:Yes
Enumeration Date:2010-05-21
Last Update Date:2019-06-26
Deactivation Date:2019-05-21
Deactivation Code:
Reactivation Date:2019-06-19
Provider Licenses
StateLicense IDTaxonomies
NY283822207Y00000X, 207YP0228X, 207YS0012X, 207YS0123X, 207YX0007X, 207YX0602X, 207YX0901X
CA134847207YP0228X, 207YS0012X, 207YS0123X, 207YX0007X, 207YX0602X, 207YX0901X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YP0228XAllopathic & Osteopathic PhysiciansOtolaryngologyPediatric Otolaryngology
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep Medicine
No207YS0123XAllopathic & Osteopathic PhysiciansOtolaryngologyFacial Plastic Surgery
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck
No207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207YX0901XAllopathic & Osteopathic PhysiciansOtolaryngologyOtology & Neurotology