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NPI Code Detail

MEDICARE: SARAH DIANNE CHICO FERNANDEZ

MEDICARE: SARAH DIANNE CHICO FERNANDEZ
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
1363A00000XPhysician AssistantPA67208CA

General Provider Information

NPI Number : 1740049899
Entity Type Code : Individual
Provider Name (Legal Business Name) : SARAH DIANNE CHICO FERNANDEZ
Provider Business Mailing Address
First Line : 8204 LONG BEACH BLVD # B
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-2011
Country : US
Telephone Number : 323-588-3300
Fax Number :
Provider Business Practice Location Address
First Line : 8204 LONG BEACH BLVD UNIT B
Second Line :
City : SOUTH GATE
State : CA
Zip : 90280-2011
Country : US
Telephone Number : 323-588-3300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/18/2024
Last Update Date : 06/05/2026

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Directions to “ SARAH DIANNE CHICO FERNANDEZ ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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