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Individual

MS. SUKUMARN SARAH MINGVIRIYA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MSHS, PA-C, ATRET

Contact information

Practice address
39400 PASEO PADRE PKWY, FREMONT, CA 94538-2310
(510) 248-3000
Mailing address
41492 ALICE ST, FREMONT, CA 94539-4533
(510) 396-5134

Taxonomy

Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
363AS0400X
Surgical Physician Assistant
015283
NY
363AS0400X
Surgical Physician Assistant
Primary
53437
CA

Other

Enumeration date
05/21/2007
Last updated
01/03/2022
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