Provider Demographics
NPI:1295994861
Name:SARAH G NGHIEM, INC.
Entity type:Organization
Organization Name:SARAH G NGHIEM, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:SARAH
Authorized Official - Middle Name:
Authorized Official - Last Name:NGHIEM
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:714-356-3836
Mailing Address - Street 1:16027 BROOKHURST ST
Mailing Address - Street 2:STE G - 127
Mailing Address - City:FOUNTAIN VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:92708-1551
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:11190 WARNER AVE
Practice Address - Street 2:STE 301
Practice Address - City:FOUNTAIN VALLEY
Practice Address - State:CA
Practice Address - Zip Code:92708-4019
Practice Address - Country:US
Practice Address - Phone:714-356-3836
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-06-08
Last Update Date:2008-06-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A8845207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty