Provider Demographics
NPI:1174743314
Name:MARTA SARMIENTO, M.D.,INC.
Entity type:Organization
Organization Name:MARTA SARMIENTO, M.D.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTA
Authorized Official - Middle Name:SARITA
Authorized Official - Last Name:SARMIENTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:714-771-2229
Mailing Address - Street 1:725 W LA VETA AVE
Mailing Address - Street 2:#200
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4403
Mailing Address - Country:US
Mailing Address - Phone:714-771-2229
Mailing Address - Fax:714-771-1108
Practice Address - Street 1:725 W LA VETA AVE
Practice Address - Street 2:#200
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4403
Practice Address - Country:US
Practice Address - Phone:714-771-2229
Practice Address - Fax:714-771-1108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-30
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54215208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G542150OtherMEDI-CAL