Provider Demographics
NPI:1922004571
Name:SYER, SARA ANNE (PA-C)
Entity Type:Individual
Prefix:MS
First Name:SARA
Middle Name:ANNE
Last Name:SYER
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:MS
Other - First Name:SARA
Other - Middle Name:ANNE
Other - Last Name:SYER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MS, PA-C
Mailing Address - Street 1:1580 VALENCIA ST
Mailing Address - Street 2:SUITE # 602,
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94110-4423
Mailing Address - Country:US
Mailing Address - Phone:415-641-2160
Mailing Address - Fax:415-641-2165
Practice Address - Street 1:1580 VALENCIA ST
Practice Address - Street 2:SUITE # 602,
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94110-4423
Practice Address - Country:US
Practice Address - Phone:415-641-2160
Practice Address - Fax:415-641-2165
Is Sole Proprietor?:No
Enumeration Date:2005-06-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPA 12265363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0PA 122650Medicare ID - Type UnspecifiedINACTIVE MEDICARE BILLING