Organization Active NPI

Kevin Sadati, DO Professional Corporation

  • Otolaryngology/Facial Plastic Surgery Physician
  • Newport Beach, CA
National Provider Identifier
1669754057
Registry record updated Sep 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
20A9343 Issued in CA
Legal business name
KEVIN SADATI, DO PROFESSIONAL CORPORATION
Practice address
400 Newport Center Dr
Suite 100
Newport Beach, CA 92660-7601
Phone
(949) 706-7776
NPI assigned
Sep 13, 2011
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 13, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Kevin S Sadati, DO
Title
President
Phone
(760) 946-5177

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207YX0905X 20A9343 CA Primary
Plastic Surgery PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208200000X 20A9343 CA

Addresses

Primary practice location

400 Newport Center Dr
Suite 100
Newport Beach, CA 92660-7601

Mailing address

27462 Paseo Boveda
San Juan Capistrano, CA 92675-1890
Phone (760) 947-5177

National Provider Directory

National Provider Directory

Locations

359 San Miguel Dr
Ste 110
Newport Beach, CA 92660
Phone (949) 706-7776

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1315872000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1315872000000",
    "number": "1669754057",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27462 PASEO BOVEDA",
            "city": "SAN JUAN CAPISTRANO",
            "state": "CA",
            "postal_code": "926751890",
            "telephone_number": "760-947-5177"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 NEWPORT CENTER DR",
            "address_2": "SUITE 100",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926607601",
            "telephone_number": "949-706-7776"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KEVIN SADATI, DO PROFESSIONAL CORPORATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-09-13",
        "last_updated": "2011-09-13",
        "status": "A",
        "authorized_official_last_name": "SADATI",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "760-946-5177",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "CA",
            "license": "20A9343",
            "primary": true
        },
        {
            "code": "208200000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Plastic Surgery",
            "state": "CA",
            "license": "20A9343",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Newport Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 13, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.