Provider Demographics
NPI:1649657487
Name:GIGUERE, SARAH MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:SARAH
Middle Name:MARIE
Last Name:GIGUERE
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 WASHINGTON ST STE 300
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92103-2227
Mailing Address - Country:US
Mailing Address - Phone:619-297-5437
Mailing Address - Fax:619-243-0722
Practice Address - Street 1:550 WASHINGTON ST STE 300
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92103-2227
Practice Address - Country:US
Practice Address - Phone:619-297-5437
Practice Address - Fax:619-243-0722
Is Sole Proprietor?:No
Enumeration Date:2015-04-30
Last Update Date:2018-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA20A15328208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA1881701332Medicaid