Provider Demographics
NPI:1255524666
Name:RANDALL J SARTE, DPM, FACFAS, A PODIATRY CORPORATION
Entity type:Organization
Organization Name:RANDALL J SARTE, DPM, FACFAS, A PODIATRY CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:RANDALL
Authorized Official - Middle Name:J
Authorized Official - Last Name:SARTE
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:916-485-9373
Mailing Address - Street 1:2322 BUTANO DRIVE
Mailing Address - Street 2:SUITE 201
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95825-0687
Mailing Address - Country:US
Mailing Address - Phone:916-485-9373
Mailing Address - Fax:916-482-7830
Practice Address - Street 1:2322 BUTANO DRIVE
Practice Address - Street 2:SUITE 201
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95825-0687
Practice Address - Country:US
Practice Address - Phone:916-485-9373
Practice Address - Fax:916-482-7830
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2013-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE1497213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ50849ZOtherBLUE SHIELD
CAZZZ05651ZMedicare PIN
CA6149390001Medicare NSC