Provider Demographics
NPI:1083739692
Name:GEORGE B. SACHS M.D. A MEDICAL CORPORATION
Entity Type:Organization
Organization Name:GEORGE B. SACHS M.D. A MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:B
Authorized Official - Last Name:SACHS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-487-6579
Mailing Address - Street 1:16407 CALLE ANA
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-1914
Mailing Address - Country:US
Mailing Address - Phone:858-705-1366
Mailing Address - Fax:858-487-2836
Practice Address - Street 1:15525 POMERADO RD
Practice Address - Street 2:SUITE E1
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-2435
Practice Address - Country:US
Practice Address - Phone:858-705-1366
Practice Address - Fax:858-487-2836
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG19140207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
A40540Medicare UPIN
G19140Medicare ID - Type Unspecified