Provider Demographics
NPI:1730139387
Name:SACHELARIE, IRINA (MD)
Entity Type:Individual
Prefix:
First Name:IRINA
Middle Name:
Last Name:SACHELARIE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1441 AVOCADO AVE., STE 301
Mailing Address - Street 2:
Mailing Address - City:NEWPORT BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:92660
Mailing Address - Country:US
Mailing Address - Phone:657-241-9805
Mailing Address - Fax:949-272-2096
Practice Address - Street 1:1441 AVOCADO AVE., STE 301
Practice Address - Street 2:
Practice Address - City:NEWPORT BEACH
Practice Address - State:CA
Practice Address - Zip Code:92660
Practice Address - Country:US
Practice Address - Phone:657-241-9805
Practice Address - Fax:949-272-2096
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2022-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD444045207RH0000X, 207RH0003X
CAC55997207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0000XAllopathic & Osteopathic PhysiciansInternal MedicineHematology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MIIS087120OtherBCBSM
PA1026311370001Medicaid
MI4866612Medicaid
MIP00319863OtherRAILROAD MEDICARE
MI4866612Medicaid
MI0N15070013Medicare PIN
PA1026311370001Medicaid