Individual
DR. JEFFREY LOUIS SUGARMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
2725 MENDOCINO AVE, SANTA ROSA, CA 95403-2805
(707) 545-4537
(707) 545-6726
Mailing address
3536 MENDOCINO AVE, STE 200, SANTA ROSA, CA 95403-3634
(707) 525-6485
(707) 573-6918
Taxonomy
Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
G85304
CA
207NP0225X
Pediatric Dermatology Physician
G85304
CA
207NS0135X
Procedural Dermatology Physician
G85304
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G853040
—
CA
05
—
1548255482
—
CA
01
—
P01774457
RAILROAD MEDICARE
CA
Enumeration date
09/16/2005
Last updated
03/28/2017
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