Provider Demographics
NPI:1073830105
Name:GARG, SACHIN KUMAR (MD)
Entity Type:Individual
Prefix:
First Name:SACHIN
Middle Name:KUMAR
Last Name:GARG
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1545 DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94143-0320
Mailing Address - Country:US
Mailing Address - Phone:415-353-7900
Mailing Address - Fax:415-353-2640
Practice Address - Street 1:1545 DIVISADERO ST
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94143-0320
Practice Address - Country:US
Practice Address - Phone:415-353-7900
Practice Address - Fax:415-353-2640
Is Sole Proprietor?:No
Enumeration Date:2010-04-29
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMT196918207R00000X, 390200000X
CAA126906207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program