Provider Demographics
NPI:1285661041
Name:SACHS, DAVID A (PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:SACHS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3521 DEL REY BLVD
Mailing Address - Street 2:
Mailing Address - City:LAS CRUCES
Mailing Address - State:NM
Mailing Address - Zip Code:88012-7708
Mailing Address - Country:US
Mailing Address - Phone:505-382-1200
Mailing Address - Fax:505-382-3521
Practice Address - Street 1:3521 DEL REY BLVD
Practice Address - Street 2:
Practice Address - City:LAS CRUCES
Practice Address - State:NM
Practice Address - Zip Code:88012-7708
Practice Address - Country:US
Practice Address - Phone:505-382-1200
Practice Address - Fax:505-382-3521
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-07-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM100103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM5788370OtherAETNA
NMN8354Medicaid
NMNM100075OtherVALUE OPTIONS
NMN847OtherBLUE CROSS
NM2505020Medicare ID - Type Unspecified