Provider Demographics
NPI:1588723159
Name:JONES-GOMBERG, SARA C (MD)
Entity type:Individual
Prefix:DR
First Name:SARA
Middle Name:C
Last Name:JONES-GOMBERG
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MISS
Other - First Name:SARA
Other - Middle Name:
Other - Last Name:JONES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:27234 VALDERRAMA DR
Mailing Address - Street 2:
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91381-0677
Mailing Address - Country:US
Mailing Address - Phone:661-341-0216
Mailing Address - Fax:
Practice Address - Street 1:27420 TOURNEY RD
Practice Address - Street 2:SUITE 100
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355-5601
Practice Address - Country:US
Practice Address - Phone:661-259-3937
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-12-08
Last Update Date:2014-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG54269207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACB203442Medicare UPIN