Healthcare Provider Details

I. General information

NPI: 1841820677
Provider Name (Legal Business Name): SARSAM CARDIOLOGY A PROFESSIONAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2020
Last Update Date: 07/10/2023
Certification Date: 07/10/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27450 YNEZ RD STE 109
TEMECULA CA
92591-4649
US

IV. Provider business mailing address

28544 CLEARVIEW ST
MURRIETA CA
92563-8606
US

V. Phone/Fax

Practice location:
  • Phone: 951-587-0070
  • Fax: 949-655-7878
Mailing address:
  • Phone: 951-587-0070
  • Fax: 949-655-7878

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State

VIII. Authorized Official

Name: SINAN HARITH N. SARSAM
Title or Position: AUTHORIZED OFFICIAL/PRESIDENT
Credential: M.D.
Phone: 951-445-9630