Healthcare Provider Details
I. General information
NPI: 1770902108
Provider Name (Legal Business Name): ERIC JORA SARKISSIAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 04/14/2014
Last Update Date: 03/31/2025
Certification Date: 03/31/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
200 W ARBOR DR
SAN DIEGO CA
92103-9000
US
IV. Provider business mailing address
FILE 57326
LOS ANGELES CA
90074-7326
US
V. Phone/Fax
- Phone: 800-926-8273
- Fax:
- Phone: 800-926-8273
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | A137721 |
| License Number State | CA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207XS0106X |
| Taxonomy | Orthopaedic Hand Surgery Physician |
| License Number | MD500002998 |
| License Number State | DC |
| # 3 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207X00000X |
| Taxonomy | Orthopaedic Surgery Physician |
| License Number | A137721 |
| License Number State | CA |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: