Provider Demographics
NPI:1437574928
Name:SARGENT, GUY EDWARD (CHES)
Entity Type:Individual
Prefix:MR
First Name:GUY
Middle Name:EDWARD
Last Name:SARGENT
Suffix:
Gender:M
Credentials:CHES
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 555567
Mailing Address - Street 2:
Mailing Address - City:CAMP PENDLETON
Mailing Address - State:CA
Mailing Address - Zip Code:92055-5567
Mailing Address - Country:US
Mailing Address - Phone:760-725-8537
Mailing Address - Fax:
Practice Address - Street 1:22190 10TH STREET
Practice Address - Street 2:
Practice Address - City:CAMP PENDLETON
Practice Address - State:CA
Practice Address - Zip Code:92055
Practice Address - Country:US
Practice Address - Phone:760-725-8537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174H00000XOther Service ProvidersHealth Educator
No1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman