Basic Information
| Provider Information | |||||||||
| NPI: | 1871663005 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | LYON | ||||||||
| FirstName: | SARA | ||||||||
| MiddleName: | JANE | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1615 BUNKER HILL WAY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939066013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317961304 | ||||||||
| FaxNumber: | 8317570291 | ||||||||
| Practice Location | |||||||||
| Address1: | 559 E ALISAL ST | ||||||||
| Address2: | SUITE 201 | ||||||||
| City: | SALINAS | ||||||||
| State: | CA | ||||||||
| PostalCode: | 939052516 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8317698800 | ||||||||
| FaxNumber: | 8314229312 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/08/2006 | ||||||||
| LastUpdateDate: | 04/18/2011 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | G69146 | CA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | BL7217272 | 01 | CA | DEA | OTHER | FHC70832F | 05 | CA | MEDICAID |