Provider Demographics
NPI:1265532816
Name:SARMIENTO, ISIDRO CABILDO (NP)
Entity type:Individual
Prefix:MR
First Name:ISIDRO
Middle Name:CABILDO
Last Name:SARMIENTO
Suffix:
Gender:M
Credentials:NP
Other - Prefix:MR
Other - First Name:ISIDRO
Other - Middle Name:CABILDO
Other - Last Name:SARMIENTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:NP
Mailing Address - Street 1:4603 E ASHFORD AVE
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92867-2267
Mailing Address - Country:US
Mailing Address - Phone:714-637-2273
Mailing Address - Fax:
Practice Address - Street 1:5901 E 7TH ST
Practice Address - Street 2:
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90822-5201
Practice Address - Country:US
Practice Address - Phone:562-826-5276
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396173363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health