Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G55876 | CA |
N | 111NI0900X | Internist | G55876 | CA |
N | 207RG0300X | Geriatric Medicine | G55876 | CA |
N | 207RR0500X | Rheumatology | G55876 | CA |
N | 2084N0400X | Neurologist | G55876 | CA |
NPI | 1083835433 |
---|---|
Provider Name | George Sarka |
First Address | Laguna Hills, CA 92653-5896 |
Second Address | Northridge, CA 91330-8270 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G55876 | MEDICAL LICENSE (01) | CA |