Provider Demographics
NPI:1467762914
Name:SARSOZO, DAVID OROLFO (IDC)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:OROLFO
Last Name:SARSOZO
Suffix:
Gender:M
Credentials:IDC
Other - Prefix:
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Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:937 FRANKLIN BLVD
Mailing Address - Street 2:NAVAL HOSPITAL LEMOORE
Mailing Address - City:LEMOORE
Mailing Address - State:CA
Mailing Address - Zip Code:93246-0001
Mailing Address - Country:US
Mailing Address - Phone:559-998-0889
Mailing Address - Fax:559-998-4289
Practice Address - Street 1:937 FRANKLIN BLVD
Practice Address - Street 2:NAVAL HOSPITAL LEMOORE
Practice Address - City:LEMOORE
Practice Address - State:CA
Practice Address - Zip Code:93246-0001
Practice Address - Country:US
Practice Address - Phone:559-998-0889
Practice Address - Fax:559-998-4289
Is Sole Proprietor?:No
Enumeration Date:2010-10-18
Last Update Date:2016-04-20
Deactivation Date:
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Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1710I1002XOther Service ProvidersMilitary Health Care ProviderIndependent Duty Corpsman
Provider Identifiers
StateIdentifier IDID TypeIssuer
1467762914OtherTRICARE