Provider Demographics
NPI:1467724195
Name:RIDDAR, SARAH (CPO)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:RIDDAR
Suffix:
Gender:F
Credentials:CPO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7930 FROST ST STE 304
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-2740
Mailing Address - Country:US
Mailing Address - Phone:858-560-4944
Mailing Address - Fax:858-560-0731
Practice Address - Street 1:7930 FROST ST STE 304
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123-2740
Practice Address - Country:US
Practice Address - Phone:858-560-4944
Practice Address - Fax:858-560-0731
Is Sole Proprietor?:No
Enumeration Date:2012-01-26
Last Update Date:2012-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist
No222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist