Provider Demographics
NPI:1801904495
Name:SARMICANIC, SCHAUL (MD)
Entity type:Individual
Prefix:
First Name:SCHAUL
Middle Name:
Last Name:SARMICANIC
Suffix:
Gender:M
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:PO BOX 9368
Mailing Address - Street 2:
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93389-9368
Mailing Address - Country:US
Mailing Address - Phone:661-326-8989
Mailing Address - Fax:
Practice Address - Street 1:1801 16TH ST
Practice Address - Street 2:SUITE A
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5002
Practice Address - Country:US
Practice Address - Phone:661-326-8989
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-25
Last Update Date:2007-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA262612086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA24787Medicare UPIN
CA00A262610Medicare PIN