David a Sack MD a Professional Medical Corporation

Organization Active NPI Addiction Psychiatry Physician · Malibu, CA

NPI 1104377613 · NPPES record last updated Jan 24, 2017

Key facts

NPI
1104377613
Entity type
Organization (NPI type 2)
Primary specialty
Addiction Psychiatry Physician 2084P0802X
License
20A13416 (CA)
Legal business name
DAVID A SACK MD A PROFESSIONAL MEDICAL CORPORATION
Practice address
20786 Cool Oak Way
Malibu, CA 90265-5318
Phone
(424) 235-2337
Fax
(310) 943-0438
NPI assigned
Oct 19, 2016
Organization subpart
No

Authorized official

Name
Mrs. Cheryl Maplesden, CPC,CHC,CHPC
Title
Sr Director RCM
Phone
(615) 540-3708

Corporate family (same tax ID) 3

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
David a Sack MD a Professional Medical Corporation (4 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatry Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2084P0800X
Addiction Psychiatry Physician
Group: 193400000X MULTIPLE SINGLE SPECIALTY GROUP
2084P0802X 20A13416 CA Yes

Addresses

Primary practice location

20786 Cool Oak Way
Malibu, CA 90265-5318

Mailing address

PO Box 671387
Dallas, TX 75267-1387
Phone (615) 567-7282

Other names

  • Elements Medical Group Doing business as

Other providers in Malibu, CA

All providers in Malibu, CA · Addiction Psychiatry Physician in California

Sources for this page

Verify at the official NPI Registry.