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NPI Code Detail

MEDICARE: DR. EMELOU SAGARAL MD

MEDICARE: DR. EMELOU SAGARAL MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207Q00000XFamily Medicine PhysicianC10007732DE

General Provider Information

NPI Number : 1205812500
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. EMELOU SAGARAL MD
Provider Business Mailing Address
First Line : 4161 REDONDO BEACH BLVD
Second Line : SUITE 201
City : LAWNDALE
State : CA
Zip : 90260-3306
Country : US
Telephone Number : 310-214-8677
Fax Number : 310-921-1213
Provider Business Practice Location Address
First Line : 1045 W REDONDO BEACH BLVD STE 300
Second Line : LA VIDA FAMILY MEDICINE
City : GARDENA
State : CA
Zip : 90247-4175
Country : US
Telephone Number : 310-352-4170
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/19/2005
Last Update Date : 12/23/2021

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