Healthcare Provider Details

I. General information

NPI: 1265745848
Provider Name (Legal Business Name): ANNAHITA K SARCON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/23/2010
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3400 MINISTRY PKWY
WESTON WI
54476-5220
US

IV. Provider business mailing address

801 N TUSTIN AVE STE 706
SANTA ANA CA
92705-3611
US

V. Phone/Fax

Practice location:
  • Phone: 715-393-1000
  • Fax:
Mailing address:
  • Phone: 714-568-6600
  • Fax: 714-245-0260

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number75529
License Number StateAZ
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberA133619
License Number StateCA
# 3
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number103446
License Number StateWI
# 4
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number162243
License Number StateMT
# 5
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberA133619
License Number StateCA
# 6
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number35.153685
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: