Provider Demographics
NPI:1245491828
Name:SOMBITO, JOEMAR S
Entity type:Individual
Prefix:MR
First Name:JOEMAR
Middle Name:S
Last Name:SOMBITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3215 PUFFIN CIRCLE
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:94533
Mailing Address - Country:US
Mailing Address - Phone:707-816-1008
Mailing Address - Fax:
Practice Address - Street 1:3215 PUFFIN CIR
Practice Address - Street 2:
Practice Address - City:FAIRFIELD
Practice Address - State:CA
Practice Address - Zip Code:94533-8915
Practice Address - Country:US
Practice Address - Phone:707-816-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-17
Last Update Date:2008-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA591607163WH0200X
343900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes343900000XTransportation ServicesNon-emergency Medical Transport (VAN)
No163WH0200XNursing Service ProvidersRegistered NurseHome Health