Healthcare Provider Details

I. General information

NPI: 1811266117
Provider Name (Legal Business Name): SARAH Z. MINASYAN MD, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/15/2011
Last Update Date: 06/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3010 BEARD RD
NAPA CA
94558-3442
US

IV. Provider business mailing address

1261 TRAVIS BLVD SUITE 200
FAIRFIELD CA
94533-4897
US

V. Phone/Fax

Practice location:
  • Phone: 707-255-8825
  • Fax: 707-252-9325
Mailing address:
  • Phone: 714-501-9831
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License NumberA82064
License Number StateCA

VIII. Authorized Official

Name: DR. SARAH Z MINASYAN
Title or Position: OWNER
Credential: M.D
Phone: 714-501-9831