Healthcare Provider Details

I. General information

NPI: 1669670592
Provider Name (Legal Business Name): SACHIN SHRIKANT PARIKH M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2007
Last Update Date: 10/21/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10385 CALVERT DR
CUPERTINO CA
95014-3807
US

IV. Provider business mailing address

10385 CALVERT DR
CUPERTINO CA
95014-3807
US

V. Phone/Fax

Practice location:
  • Phone: 650-396-7111
  • Fax:
Mailing address:
  • Phone: 650-396-7111
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2082S0099X
TaxonomyPlastic Surgery Within the Head and Neck (Plastic Surgery) Physician
License NumberA96960
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License NumberA96960
License Number StateCA
# 3
Primary TaxonomyN
Taxonomy Code207YS0123X
TaxonomyFacial Plastic Surgery Physician
License Number256203-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: