Provider Demographics
NPI:1972268159
Name:SIGMA EAR NOSE & THROAT
Entity Type:Organization
Organization Name:SIGMA EAR NOSE & THROAT
Other - Org Name:SIGMA ENT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:CHRISTIAN
Authorized Official - Middle Name:P
Authorized Official - Last Name:CONDERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:510-483-3565
Mailing Address - Street 1:1700 SAN PABLO AVE STE F
Mailing Address - Street 2:
Mailing Address - City:PINOLE
Mailing Address - State:CA
Mailing Address - Zip Code:94564-2082
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1700 SAN PABLO AVE STE F
Practice Address - Street 2:
Practice Address - City:PINOLE
Practice Address - State:CA
Practice Address - Zip Code:94564-2082
Practice Address - Country:US
Practice Address - Phone:510-724-6662
Practice Address - Fax:510-724-1923
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-03
Last Update Date:2022-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty