MEDICARE: MISS SARA NATOUR PA-C

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363A00000X	Physician Assistant	62507	CA

General Provider Information

NPI Number	:	1023710787
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MISS SARA NATOUR PA-C

Provider Business Mailing Address
First Line	:	PO BOX 2696
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92406-2696
Country	:	US
Telephone Number	:	909-747-2715
Fax Number	:

Provider Business Practice Location Address
First Line	:	2334 N SIERRA WAY
Second Line	:
City	:	SAN BERNARDINO
State	:	CA
Zip	:	92405-3546
Country	:	US
Telephone Number	:	909-747-2715
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/20/2023
Last Update Date	:	03/20/2023

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