Provider Demographics
NPI:1225000755
Name:SARKIS, NAIRY (MD)
Entity Type:Individual
Prefix:
First Name:NAIRY
Middle Name:
Last Name:SARKIS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2200
Mailing Address - Street 2:
Mailing Address - City:REDLANDS
Mailing Address - State:CA
Mailing Address - Zip Code:92373-0722
Mailing Address - Country:US
Mailing Address - Phone:909-335-4148
Mailing Address - Fax:
Practice Address - Street 1:1600 E CITRUS AVE
Practice Address - Street 2:STE A
Practice Address - City:REDLANDS
Practice Address - State:CA
Practice Address - Zip Code:92374-4270
Practice Address - Country:US
Practice Address - Phone:909-794-3682
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-07
Last Update Date:2021-12-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN47769207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN590143000Medicaid
MN590143000Medicaid
I38606Medicare UPIN