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General NPI Number Information
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NPI Number | 1568620938
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Entity Type | Individual
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Provider Name | SARA EVONA DAHLE DPM
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Gender | Female
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Dates
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Enumeration Date | 06/01/2008
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Last Update Date | 06/01/2008
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Provider Practice Location Address
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Address Line | 10535 HOSPITAL WAY
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City | MATHER
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State | CA
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Zip | 95655-4200
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Country | US
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Telephone | 916-543-9069
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Fax | 916-364-0239
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Provider Business Mailing Address
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Address Line | 439 VASQUEZ CT APT. #3
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City | SUNNYVALE
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State | CA
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Zip | 94086-7368
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Country | US
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Telephone | 408-858-7539
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Fax | 303-756-1821
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213ES0103X
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Taxonomy Name | Foot & Ankle Surgery Podiatrist
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License Number | E 4763
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License Number State | CA
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