Healthcare Provider Details

I. General information

NPI: 1669324182
Provider Name (Legal Business Name): SARA SURGICAL ARTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/10/2026
Last Update Date: 02/10/2026
Certification Date: 02/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4213 DALE RD STE B-6
MODESTO CA
95356-8505
US

IV. Provider business mailing address

4213 DALE RD STE B-6
MODESTO CA
95356-8505
US

V. Phone/Fax

Practice location:
  • Phone: 209-353-4727
  • Fax:
Mailing address:
  • Phone: 209-353-4727
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: VINESH KORLAKUNTA
Title or Position: MANAGING PARTNER
Credential:
Phone: 209-353-4727