Provider Demographics
NPI:1760483085
Name:SARTE, RANDALL J (DPM)
Entity Type:Individual
Prefix:
First Name:RANDALL
Middle Name:J
Last Name:SARTE
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2322 BUTANO DR
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0687
Mailing Address - Country:US
Mailing Address - Phone:916-485-9373
Mailing Address - Fax:916-482-7830
Practice Address - Street 1:2322 BUTANO DR
Practice Address - Street 2:SUITE 201
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0687
Practice Address - Country:US
Practice Address - Phone:916-485-9373
Practice Address - Fax:916-482-7830
Is Sole Proprietor?:No
Enumeration Date:2005-08-09
Last Update Date:2009-02-25
Deactivation Date:2006-03-23
Deactivation Code:
Reactivation Date:2006-03-28
Provider Licenses
StateLicense IDTaxonomies
CAE1497213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E14971Medicare ID - Type UnspecifiedMEDICARE ID#
CA5036460001Medicare NSC
CAT10979Medicare UPIN
CA000E14972Medicare PIN