Provider Demographics
NPI:1811034143
Name:SACKS, RICHARD S (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:S
Last Name:SACKS
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:7910 FROST STREET
Mailing Address - Street 2:SUITE 245
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123
Mailing Address - Country:US
Mailing Address - Phone:858-650-5037
Mailing Address - Fax:858-650-5039
Practice Address - Street 1:7910 FROST STREET
Practice Address - Street 2:SUITE 245
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92123
Practice Address - Country:US
Practice Address - Phone:858-650-5037
Practice Address - Fax:858-650-5039
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-30
Last Update Date:2012-11-26
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Provider Licenses
StateLicense IDTaxonomies
CAA89585207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease