Provider Demographics
NPI:1174537062
Name:SACHS, BRUCE JOSEPH (MD)
Entity type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:JOSEPH
Last Name:SACHS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:501 N EL CAMINO REAL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:ENCINITAS
Mailing Address - State:CA
Mailing Address - Zip Code:92024-1335
Mailing Address - Country:US
Mailing Address - Phone:760-944-6520
Mailing Address - Fax:760-944-6525
Practice Address - Street 1:501 N EL CAMINO REAL
Practice Address - Street 2:SUITE 100
Practice Address - City:ENCINITAS
Practice Address - State:CA
Practice Address - Zip Code:92024-1335
Practice Address - Country:US
Practice Address - Phone:760-944-6520
Practice Address - Fax:760-944-6525
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-12-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA45375207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE07569Medicare UPIN
CAA45375AMedicare PIN
CAA45375Medicare ID - Type UnspecifiedMEDICARE