Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 213E00000X | Podiatrist | CPO02701 | |
N | 222Z00000X | Podiatrist | CPO02701 | |
Y | 224P00000X | Prosthetist | CPO02701 |
NPI | 1326206392 |
---|---|
Provider Name | Mr. Keith Ryan Sardo |
First Address | Salinas, CA 93901-4026 |
Second Address | Salinas, CA 93901-4026 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/05/2008 |
Last Update Date | 03/12/2012 |