Provider Demographics
NPI:1821529579
Name:DOLISCA, SARAH-BIANCA (MD)
Entity Type:Individual
Prefix:
First Name:SARAH-BIANCA
Middle Name:
Last Name:DOLISCA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5601 DEER VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:ANTIOCH
Mailing Address - State:CA
Mailing Address - Zip Code:94531-8577
Mailing Address - Country:US
Mailing Address - Phone:678-907-0342
Mailing Address - Fax:
Practice Address - Street 1:5601 DEER VALLEY RD
Practice Address - Street 2:
Practice Address - City:ANTIOCH
Practice Address - State:CA
Practice Address - Zip Code:94531-8577
Practice Address - Country:US
Practice Address - Phone:678-907-0342
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-24
Last Update Date:2022-08-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA177132207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty