1558670232 NPI number — SARAH ELIZABETH TSENG PHARMD

Table of content: SARAH ELIZABETH TSENG PHARMD (NPI 1558670232)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1558670232 NPI number — SARAH ELIZABETH TSENG PHARMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
TSENG
Provider First Name:
SARAH
Provider Middle Name:
ELIZABETH
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
PHARMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SHERER
Provider Other First Name:
SARAH
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1558670232
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
11/30/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2155 IRON POINT ROAD
Provider Second Line Business Mailing Address:
MEDICINE 1, 3RD FLOOR ROOM F3144
Provider Business Mailing Address City Name:
FOLSOM
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
95630
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
916-817-5320
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2155 IRON POINT RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FOLSOM
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
95630-8707
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
916-817-5320
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
09/29/2010

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 183500000X , with the licence number:  64216 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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