Provider Demographics
NPI:1154716199
Name:VEGA, SARAH TERESITA (MD)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:TERESITA
Last Name:VEGA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4645 CARMEL MOUNTAIN RD STE 204
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92130-6630
Mailing Address - Country:US
Mailing Address - Phone:858-283-7550
Mailing Address - Fax:
Practice Address - Street 1:4645 CARMEL MOUNTAIN RD STE 204
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92130-6630
Practice Address - Country:US
Practice Address - Phone:858-283-7550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-06
Last Update Date:2024-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA144123208000000X, 2080C0008X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080C0008XAllopathic & Osteopathic PhysiciansPediatricsChild Abuse Pediatrics
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics