Provider Demographics
NPI:1568620938
Name:DAHLE, SARA EVONA (DPM)
Entity Type:Individual
Prefix:DR
First Name:SARA
Middle Name:EVONA
Last Name:DAHLE
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:439 VASQUEZ CT
Mailing Address - Street 2:APT. #3
Mailing Address - City:SUNNYVALE
Mailing Address - State:CA
Mailing Address - Zip Code:94086-7368
Mailing Address - Country:US
Mailing Address - Phone:408-858-7539
Mailing Address - Fax:303-756-1821
Practice Address - Street 1:10535 HOSPITAL WAY
Practice Address - Street 2:
Practice Address - City:MATHER
Practice Address - State:CA
Practice Address - Zip Code:95655-4200
Practice Address - Country:US
Practice Address - Phone:916-543-9069
Practice Address - Fax:916-364-0239
Is Sole Proprietor?:No
Enumeration Date:2008-06-01
Last Update Date:2008-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE 4763213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery