Provider Demographics
NPI:1780745661
Name:SORKIN, ANNA (DPM)
Entity type:Individual
Prefix:DR
First Name:ANNA
Middle Name:
Last Name:SORKIN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5516 VALLEJO ST
Mailing Address - Street 2:
Mailing Address - City:EMERYVILLE
Mailing Address - State:CA
Mailing Address - Zip Code:94608-2624
Mailing Address - Country:US
Mailing Address - Phone:510-444-8733
Mailing Address - Fax:510-444-3668
Practice Address - Street 1:419 30TH ST STE A
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94609-3301
Practice Address - Country:US
Practice Address - Phone:510-444-8733
Practice Address - Fax:510-444-3668
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-13
Last Update Date:2012-05-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4217213ES0131X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0131XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA000E42170Medicaid
CA4556160001Medicare NSC
CA000E42170Medicare ID - Type Unspecified
CA000E42170Medicaid