Healthcare Provider Details

I. General information

NPI: 1730268251
Provider Name (Legal Business Name): JOSEPH HARRY SUGERMAN M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/03/2006
Last Update Date: 03/13/2026
Certification Date: 03/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

435 N ROXBURY DR STE 303
BEVERLY HILLS CA
90210-5005
US

IV. Provider business mailing address

435 N ROXBURY DR STE 303
BEVERLY HILLS CA
90210-5005
US

V. Phone/Fax

Practice location:
  • Phone: 310-274-6005
  • Fax: 310-274-3570
Mailing address:
  • Phone: 310-274-6005
  • Fax: 310-274-3570

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberG27147
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: