Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | 19811 | CA |
NPI | 1720357783 |
---|---|
Provider Name | Pablo Sarmiento |
First Address | Sacramento, CA 95811-5216 |
Second Address | Sacramento, CA 95811-5216 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/12/2011 |
Last Update Date | 03/01/2022 |