Provider Demographics
NPI:1457571697
Name:SARMIENTO, MARTA SARITA (MD)
Entity Type:Individual
Prefix:DR
First Name:MARTA
Middle Name:SARITA
Last Name:SARMIENTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MARTA
Other - Middle Name:SARITA
Other - Last Name:VALDIVIESO SARMIENTO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:725 W LA VETA AVE STE 240
Mailing Address - Street 2:
Mailing Address - City:ORANGE
Mailing Address - State:CA
Mailing Address - Zip Code:92868-4446
Mailing Address - Country:US
Mailing Address - Phone:714-771-2229
Mailing Address - Fax:714-771-1108
Practice Address - Street 1:725 W LA VETA AVE STE 240
Practice Address - Street 2:
Practice Address - City:ORANGE
Practice Address - State:CA
Practice Address - Zip Code:92868-4446
Practice Address - Country:US
Practice Address - Phone:714-771-2229
Practice Address - Fax:714-771-1108
Is Sole Proprietor?:No
Enumeration Date:2007-04-30
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54215208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G542150OtherMEDI CAL