Provider Demographics
NPI:1144231853
Name:SACHS, MARSHALL H (MD)
Entity Type:Individual
Prefix:
First Name:MARSHALL
Middle Name:H
Last Name:SACHS
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 1:5767 W CENTURY BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5632
Mailing Address - Country:US
Mailing Address - Phone:310-829-9935
Mailing Address - Fax:310-829-1077
Practice Address - Street 1:200 MEDICAL PLAZA
Practice Address - Street 2:#265
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90024
Practice Address - Country:US
Practice Address - Phone:310-206-6923
Practice Address - Fax:310-829-1077
Is Sole Proprietor?:No
Enumeration Date:2006-08-10
Last Update Date:2010-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG9323207R00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G93230Medicaid
CA00G93230Medicaid
CAWG9323AMedicare PIN