Healthcare Provider Details

I. General information

NPI: 1043166648
Provider Name (Legal Business Name): DUSAN SAJIC M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 07/29/2026
Certification Date: 07/29/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N CAMDEN DRIVE
BEVERLY HILLS CA
90210
US

IV. Provider business mailing address

33 FARLEY DRIVE SUITE 8
GUELPH ON
NIL 0B7
CA

V. Phone/Fax

Practice location:
  • Phone: 310-651-6267
  • Fax: 519-822-0403
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License NumberC204913
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: