Provider Demographics
NPI:1295296002
Name:PADUA, SARAH ALEXIS PAUL (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:ALEXIS PAUL
Last Name:PADUA
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 1:325 DISTEL CIR
Mailing Address - Street 2:
Mailing Address - City:LOS ALTOS
Mailing Address - State:CA
Mailing Address - Zip Code:94022-1408
Mailing Address - Country:US
Mailing Address - Phone:707-541-7902
Mailing Address - Fax:707-573-5413
Practice Address - Street 1:34 MARK WEST SPRINGS RD FL 2
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95403-1766
Practice Address - Country:US
Practice Address - Phone:707-541-7902
Practice Address - Fax:707-573-5413
Is Sole Proprietor?:No
Enumeration Date:2019-03-26
Last Update Date:2024-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA188551207V00000X
CA188551207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA188551OtherSTATE MEDICAL LICENSE
OH107028169-00Medicaid