Provider Demographics
NPI:1205812500
Name:SAGARAL, EMELOU (MD)
Entity type:Individual
Prefix:DR
First Name:EMELOU
Middle Name:
Last Name:SAGARAL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:EMELOU
Other - Middle Name:
Other - Last Name:SAGARAL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:4161 REDONDO BEACH BLVD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:LAWNDALE
Mailing Address - State:CA
Mailing Address - Zip Code:90260-3306
Mailing Address - Country:US
Mailing Address - Phone:310-214-8677
Mailing Address - Fax:310-921-1213
Practice Address - Street 1:1045 W REDONDO BEACH BLVD STE 300
Practice Address - Street 2:LA VIDA FAMILY MEDICINE
Practice Address - City:GARDENA
Practice Address - State:CA
Practice Address - Zip Code:90247-4175
Practice Address - Country:US
Practice Address - Phone:310-352-4170
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2021-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEC10007732207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine