Provider Demographics
NPI:1518167857
Name:SMITH, SARAH ELIZABETH (DO)
Entity Type:Individual
Prefix:DR
First Name:SARAH
Middle Name:ELIZABETH
Last Name:SMITH
Suffix:
Gender:F
Credentials:DO
Other - Prefix:DR
Other - First Name:SARAH
Other - Middle Name:ELIZABETH
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DO
Mailing Address - Street 1:CENTRAL CALIFORNIA FACULTY MEDICAL GROUP
Mailing Address - Street 2:4910 E. CLINTON AVE. SUITE #101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93727-1505
Mailing Address - Country:US
Mailing Address - Phone:559-453-5258
Mailing Address - Fax:559-453-5233
Practice Address - Street 1:MEDICAL ED. CHILDREN'S HOSPITAL CENTRAL CALIFORNIA
Practice Address - Street 2:9300 VALLEY CHILDREN'S PLACE
Practice Address - City:MADERA
Practice Address - State:CA
Practice Address - Zip Code:93638
Practice Address - Country:US
Practice Address - Phone:559-353-5174
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-24
Last Update Date:2007-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9510208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics