MEDICARE: DR. SARAH EP FORSYTHE M.D.

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	207Q00000X	Family Medicine Physician	A95616	CA

General Provider Information

NPI Number	:	1265435622
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SARAH EP FORSYTHE M.D.

Provider Business Mailing Address
First Line	:	6233 MCFARLAND RD
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95212-9475
Country	:	US
Telephone Number	:	209-423-1093
Fax Number	:

Provider Business Practice Location Address
First Line	:	6233 MCFARLAND RD
Second Line	:
City	:	STOCKTON
State	:	CA
Zip	:	95212-9475
Country	:	US
Telephone Number	:	209-423-1093
Fax Number	:

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

Provider Enumeration Date	:	05/31/2005
Last Update Date	:	07/08/2007

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