Provider Demographics
NPI:1992878151
Name:SARGEANT, ULIN (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:ULIN
Middle Name:
Last Name:SARGEANT
Suffix:
Gender:F
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2063
Mailing Address - Street 2:
Mailing Address - City:MONROVIA
Mailing Address - State:CA
Mailing Address - Zip Code:91017-6063
Mailing Address - Country:US
Mailing Address - Phone:877-254-4496
Mailing Address - Fax:877-254-4496
Practice Address - Street 1:1227 BUENA VISTA ST
Practice Address - Street 2:SUITE #F
Practice Address - City:DUARTE
Practice Address - State:CA
Practice Address - Zip Code:91010-2486
Practice Address - Country:US
Practice Address - Phone:877-254-4496
Practice Address - Fax:877-254-4496
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2024-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA972562083P0901X, 208D00000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
No208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAEAP70768FMedicaid
CAHAP70768FMedicaid
CACMM70768FMedicaid
CAFHC70768FMedicaid
CAFHC70768FMedicaid
CACMM70768FMedicaid
CAWI4388Medicare ID - Type UnspecifiedMEDICARE