Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | A107035 | CA |
NPI | 1003013335 |
---|---|
Provider Name | Juan Fernando Sarti |
First Address | Modesto, CA 95355-4201 |
Second Address | Stockton, CA 95209-2839 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/06/2007 |
Last Update Date | 02/02/2011 |