Provider Demographics
NPI:1245789189
Name:SARMIENTO, HAROLD CRUZ (NP)
Entity Type:Individual
Prefix:MR
First Name:HAROLD
Middle Name:CRUZ
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5073 HERMOSA AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90041-2073
Mailing Address - Country:US
Mailing Address - Phone:310-903-9770
Mailing Address - Fax:
Practice Address - Street 1:99 N LA CIENEGA BLVD STE 200
Practice Address - Street 2:
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2285
Practice Address - Country:US
Practice Address - Phone:310-657-9353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-03
Last Update Date:2021-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95005096363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health