Gerald M. Sacks M.D. Inc

Primary specialty

Pain Clinic/CenterTaxonomy code 261QP3300X

License

G66354 Issued in CA

Legal business name

GERALD M. SACKS M.D. INC

Practice address

2021 Santa Monica Blvd Ste 300E
Santa Monica, CA 90404-2148

Phone

(310) 264-7314

Fax

(310) 315-4984

NPI assigned

Nov 9, 2006

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Gerald M Sacks, M.D.NPI 1205906781

Title

President

Phone

(310) 264-7314

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Gerald M Sacks, M.D.

  • Pain Medicine (Anesthesiology) Physician
  • Santa Monica, CA
  • NPI 1205906781
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1517875200000",
    "number": "1437229887",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 300E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042148",
            "telephone_number": "310-264-7314",
            "fax_number": "310-315-4984"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2021 SANTA MONICA BLVD STE 300E",
            "city": "SANTA MONICA",
            "state": "CA",
            "postal_code": "904042148",
            "telephone_number": "310-264-7314",
            "fax_number": "310-315-4984"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GERALD M. SACKS M.D. INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-09",
        "last_updated": "2018-02-06",
        "status": "A",
        "authorized_official_last_name": "SACKS",
        "authorized_official_first_name": "GERALD",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "310-264-7314",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "261QP3300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Pain",
            "state": "CA",
            "license": "G66354",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Pain Clinic/Center in Santa Monica, CA
• Providers in Santa Monica, CA by specialty
• Pain Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 6, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.