Provider Demographics
NPI:1639416209
Name:SELLERS, SAHRA ANTOINETTE (DPM)
Entity Type:Individual
Prefix:DR
First Name:SAHRA
Middle Name:ANTOINETTE
Last Name:SELLERS
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2299 POST ST STE 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3473
Mailing Address - Country:US
Mailing Address - Phone:415-292-0638
Mailing Address - Fax:415-292-0718
Practice Address - Street 1:2299 POST ST STE 205
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3473
Practice Address - Country:US
Practice Address - Phone:415-292-0638
Practice Address - Fax:415-292-0718
Is Sole Proprietor?:No
Enumeration Date:2013-01-15
Last Update Date:2024-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAEL1839213ES0103X
CAE5049213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAHE335ZMedicare PIN