Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LF0000X | Nurse Practitioner - Family Medicine | 20282 | CA |
NPI | 1003117763 |
---|---|
Provider Name | Amy M Sorgent |
First Address | San Diego, CA 92111-3717 |
Second Address | San Diego, CA 92111-3717 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/11/2010 |
Last Update Date | 11/11/2010 |