Basic Information
Provider Information
NPI: 1174541866
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WELSH
FirstName: SARAH
MiddleName: LYNN
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 848 BELL ST
Address2:  
City: RENO
State: NV
PostalCode: 895033646
CountryCode: US
TelephoneNumber: 3122030293
FaxNumber:  
Practice Location
Address1: 27200 CALAROGA AVE
Address2:  
City: HAYWARD
State: CA
PostalCode: 945454339
CountryCode: US
TelephoneNumber: 5102644026
FaxNumber:  
Other Information
ProviderEnumerationDate: 07/18/2006
LastUpdateDate: 12/10/2008
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207P00000X20A9608CAY Allopathic & Osteopathic PhysiciansEmergency Medicine 
207P00000XDO1396NVN Allopathic & Osteopathic PhysiciansEmergency Medicine 

No ID Information.


Home