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General NPI Number Information
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NPI Number | 1194747089
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Entity Type | Organization
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Legal Business Name | SARAH J PORKKA MD MEDICAL CORPORATION
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Dates
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Enumeration Date | 07/23/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 1100 TRANCAS ST SUITE 211
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City | NAPA
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State | CA
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Zip | 94558-2908
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Country | US
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Telephone | 707-224-4250
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Fax | 707-224-4435
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Provider Business Mailing Address
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Address Line | 3330 STERLING CT
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City | NAPA
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State | CA
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Zip | 94558-4262
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Country | US
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Telephone | 707-224-4250
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Fax | 707-224-4435
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Authorized Official
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Title or Position | PRESIDENT/PHYSICIAN
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Name | SARAH J PORKKA
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Credential | MD
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Telephone | 707-224-4250
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207N00000X
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Taxonomy Name | Dermatology Physician
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License Number | A68057
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License Number State | CA
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