Individual
VINCENT W SAGENDORF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
10 SANTA ROSA ST, STE. 201, SAN LUIS OBISPO, CA 93405-5825
(805) 544-7246
(805) 782-8097
Mailing address
PO BOX 4659, SAN LUIS OBISPO, CA 93403-4659
(805) 786-4878
(805) 597-8354
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
CRNA225
CA
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA000317
NV
Other
Enumeration date
01/05/2006
Last updated
02/08/2011
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