Provider Demographics
NPI:1891751640
Name:SARGENT, MARTINE A (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTINE
Middle Name:A
Last Name:SARGENT
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 1:910 BAY ST APT 9
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-1166
Mailing Address - Country:US
Mailing Address - Phone:415-378-0982
Mailing Address - Fax:
Practice Address - Street 1:1191 PHELPS AVE
Practice Address - Street 2:
Practice Address - City:COALINGA
Practice Address - State:CA
Practice Address - Zip Code:93210-9609
Practice Address - Country:US
Practice Address - Phone:559-934-6400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-21
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA87550207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A875500Medicaid
CAP00259658OtherRAILROAD
CA00A875500Medicare ID - Type UnspecifiedMEDICARE
CAP00259658OtherRAILROAD