Healthcare Provider Details

I. General information

NPI: 1083526594
Provider Name (Legal Business Name): GENESIS SARDINAS PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

801 TIOGA AVE
SAND CITY CA
93955-3050
US

IV. Provider business mailing address

PO BOX 2085
MONTEREY CA
93942-2085
US

V. Phone/Fax

Practice location:
  • Phone: 831-899-2481
  • Fax:
Mailing address:
  • Phone: 786-357-2208
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberPS71483
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code183500000X
TaxonomyPharmacist
License NumberRPH93181
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: