Provider Demographics
NPI:1760578397
Name:SAWCER, DAVID E (MD, PHD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:E
Last Name:SAWCER
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2275 HUNTINGTON DR # 854
Mailing Address - Street 2:
Mailing Address - City:SAN MARINO
Mailing Address - State:CA
Mailing Address - Zip Code:91108-2640
Mailing Address - Country:US
Mailing Address - Phone:626-864-0019
Mailing Address - Fax:310-422-7118
Practice Address - Street 1:2275 HUNTINGTON DR # 854
Practice Address - Street 2:
Practice Address - City:SAN MARINO
Practice Address - State:CA
Practice Address - Zip Code:91108-2640
Practice Address - Country:US
Practice Address - Phone:626-864-0019
Practice Address - Fax:310-422-7118
Is Sole Proprietor?:No
Enumeration Date:2006-10-04
Last Update Date:2015-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA85735207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A857350Medicaid
H44316Medicare UPIN
WA85735AMedicare ID - Type Unspecified