Provider Demographics
NPI:1700883006
Name:SAUL, GEORGE M (MD)
Entity Type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:M
Last Name:SAUL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:G. MICHAEL
Other - Middle Name:
Other - Last Name:SAUL
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:6327 N FRESNO ST
Mailing Address - Street 2:SUITE #104
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93710-5236
Mailing Address - Country:US
Mailing Address - Phone:559-431-4020
Mailing Address - Fax:559-431-4589
Practice Address - Street 1:1303 E. HERNDON AVE.
Practice Address - Street 2:MAIL STOP 35
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720
Practice Address - Country:US
Practice Address - Phone:559-431-4020
Practice Address - Fax:559-431-4589
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-30
Last Update Date:2015-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG39272207RC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G392720Medicaid
CA00G392720Medicare ID - Type Unspecified
CAA47764Medicare UPIN