Basic Information
| Provider Information | |||||||||
| NPI: | 1255945663 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | NICHOLAS C. SAGUAN, MD INC. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 220 STANDIFORD AVE STE F | ||||||||
| Address2: | |||||||||
| City: | MODESTO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 953501159 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2095795628 | ||||||||
| FaxNumber: | 2095795637 | ||||||||
| Practice Location | |||||||||
| Address1: | 1818 N ORANGE GROVE AVE STE 307 | ||||||||
| Address2: | |||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917673028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9093262853 | ||||||||
| FaxNumber: | 9093267068 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/02/2020 | ||||||||
| LastUpdateDate: | 11/17/2020 | ||||||||
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| AuthorizedOfficialLastName: | SAGUAN | ||||||||
| AuthorizedOfficialFirstName: | NICHOLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | MD/OWNER | ||||||||
| AuthorizedOfficialTelephone: | 9093262853 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
| NPICertificationDate: | 11/17/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0129X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Surgery | Vascular Surgery |
No ID Information.