Healthcare Provider Details

I. General information

NPI: 1275827941
Provider Name (Legal Business Name): SARAH BROOKE FLEISIG M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2011
Last Update Date: 05/22/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 TRANCAS ST STE 256
NAPA CA
94558
US

IV. Provider business mailing address

1100 TRANCAS ST STE 256
NAPA CA
94558-2921
US

V. Phone/Fax

Practice location:
  • Phone: 707-253-7161
  • Fax: 707-253-0476
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License Number56695
License Number StateCT
# 2
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberA152713
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: