Provider Demographics
NPI:1821578691
Name:KANTARI, SARAH SAMIR
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:SAMIR
Last Name:KANTARI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:26601 EL MAR DR
Mailing Address - Street 2:
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6105
Mailing Address - Country:US
Mailing Address - Phone:949-547-4334
Mailing Address - Fax:
Practice Address - Street 1:26601 EL MAR DR
Practice Address - Street 2:
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6105
Practice Address - Country:US
Practice Address - Phone:949-547-4334
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-08-20
Last Update Date:2018-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program