Provider Demographics
NPI:1023071552
Name:SAR, LYDIA NARY (RN)
Entity type:Individual
Prefix:MRS
First Name:LYDIA
Middle Name:NARY
Last Name:SAR
Suffix:
Gender:F
Credentials:RN
Other - Prefix:MRS
Other - First Name:LYDIA
Other - Middle Name:NARY
Other - Last Name:NGOY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:RN
Mailing Address - Street 1:10921 ROBERTA STR
Mailing Address - Street 2:
Mailing Address - City:CERRITOS
Mailing Address - State:CA
Mailing Address - Zip Code:90703
Mailing Address - Country:US
Mailing Address - Phone:562-865-5103
Mailing Address - Fax:310-229-3554
Practice Address - Street 1:2080 CENTURY PARK E
Practice Address - Street 2:STE 1005
Practice Address - City:LAS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90067-2013
Practice Address - Country:US
Practice Address - Phone:310-229-3555
Practice Address - Fax:310-229-3554
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-04-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA549084163WX0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0200XNursing Service ProvidersRegistered NurseOncology