Charles Sangmoah

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

21348 Issued in CA

Practice address

2635 Walnut St
Huntington Park, CA 90255

Phone

(323) 586-0740

NPI assigned

Jun 4, 2011

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

Credentials

Physician Assistant

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1307145600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1459468800000",
    "number": "1093009359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2635 WALNUT ST",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "90255"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 WALNUT ST",
            "city": "HUNTINGTON PARK",
            "state": "CA",
            "postal_code": "90255",
            "telephone_number": "323-586-0740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SANGMOAH",
        "first_name": "CHARLES",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2011-06-04",
        "last_updated": "2016-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "CA",
            "license": "21348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Patricia Geovana Sanchez, MSN, NP-C
• Paul Sanchez, D.D.S.
• Delvon Sanders
• Tina Sandoval
• Viridiana Sandoval, PPS
• Fidel Santa Cruz, MD
• Santa Rosa de Lima Medical Clinic Inc.
• Emmanuel Santana, LCSW 79744
• Claudia Raquel Santis, NURSE PRACTITIONER
• Edna Sarino, NP, FNP-C

• Physician Assistant in Huntington Park, CA
• Providers in Huntington Park, CA by specialty
• Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.