Provider Demographics
NPI:1205082161
Name:STANOWICZ, SARAH (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:
Last Name:STANOWICZ
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 1:1506 E CHAPMAN AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92866-2231
Mailing Address - Country:US
Mailing Address - Phone:714-538-8556
Mailing Address - Fax:714-538-1082
Practice Address - Street 1:1506 E CHAPMAN AVE
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92866-2231
Practice Address - Country:US
Practice Address - Phone:714-538-8556
Practice Address - Fax:714-538-1082
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-12
Last Update Date:2011-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112353207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA112353OtherMEDICAL LICENSE
CA273669146OtherEIN
CADS203AMedicare PIN