Provider Demographics
NPI:1629405774
Name:SACHA COMDEN MD A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:SACHA COMDEN MD A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:SACHA
Authorized Official - Middle Name:
Authorized Official - Last Name:COMDEN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-729-4059
Mailing Address - Street 1:1830 TEVIS AVE
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90815-4544
Mailing Address - Country:US
Mailing Address - Phone:310-360-7690
Mailing Address - Fax:310-360-7694
Practice Address - Street 1:8920 WILSHIRE BLVD
Practice Address - Street 2:SUITE 310
Practice Address - City:BEVERLY HILLS
Practice Address - State:CA
Practice Address - Zip Code:90211-2007
Practice Address - Country:US
Practice Address - Phone:310-360-7690
Practice Address - Fax:310-360-7694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-10-03
Last Update Date:2013-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112824207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty