Healthcare Provider Details

I. General information

NPI: 1568624872
Provider Name (Legal Business Name): SHEILA SADANG SAGUINSIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/27/2008
Last Update Date: 12/14/2021
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7373 WEST LN
STOCKTON CA
95210-3377
US

IV. Provider business mailing address

5865 ACACIA CIR APARTMENT 1411
EL PASO TX
79912-4868
US

V. Phone/Fax

Practice location:
  • Phone: 209-476-3484
  • Fax:
Mailing address:
  • Phone: 240-273-2613
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA116934
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberBP10031886
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: