Provider Demographics
NPI:1922292283
Name:LANGHORNE, SHERRI (DO,)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:LANGHORNE
Suffix:
Gender:F
Credentials:DO,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:66675 PIERSON BLVD
Mailing Address - Street 2:
Mailing Address - City:DESERT HOT SPRINGS
Mailing Address - State:CA
Mailing Address - Zip Code:92240-3737
Mailing Address - Country:US
Mailing Address - Phone:760-676-5240
Mailing Address - Fax:858-634-6946
Practice Address - Street 1:66675 PIERSON BOULEVARD
Practice Address - Street 2:
Practice Address - City:DESERT HOT SPRINGS
Practice Address - State:CA
Practice Address - Zip Code:92240
Practice Address - Country:US
Practice Address - Phone:760-676-5240
Practice Address - Fax:858-634-6946
Is Sole Proprietor?:No
Enumeration Date:2007-08-30
Last Update Date:2015-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A9634208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA0020A9634Medicaid