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General NPI Number Information
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NPI Number | 1821143165
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Entity Type | Individual
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Provider Name | ENRICO L SARMIENTO PA-C
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Gender | Male
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Dates
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Enumeration Date | 01/25/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | BLDG 2496 BAUER RD BMC MIRAMAR
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City | SAN DIEGO
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State | CA
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Zip | 92145
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Country | US
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Telephone | 858-577-9864
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Fax |
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Provider Business Mailing Address
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Address Line | 11041 ICE SKATE PL
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City | SAN DIEGO
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State | CA
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Zip | 92126-4852
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Country | US
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Telephone | 858-547-9738
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Fax |
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | NCCPA# 1045348
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License Number State |
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