John Charles Sacoolidge, MD

Primary specialty

Anatomic Pathology & Clinical Pathology PhysicianTaxonomy code 207ZP0102X

License

G49163 Issued in CA

Practice address

14445 Olive View Drive
Room 1a 133 Olive View UCLA Medical Center
Sylmar, CA 91342

Phone

(818) 364-4036

Fax

(818) 364-4065

NPI assigned

Jul 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1152662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1447285820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "address_2": "ROOM 1A 133 OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-4036",
            "fax_number": "818-364-4065"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14445 OLIVE VIEW DRIVE",
            "address_2": "ROOM 1A 133 OLIVE VIEW UCLA MEDICAL CENTER",
            "city": "SYLMAR",
            "state": "CA",
            "postal_code": "91342",
            "telephone_number": "818-364-4036",
            "fax_number": "818-364-4065"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SACOOLIDGE",
        "first_name": "JOHN",
        "middle_name": "CHARLES",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207ZP0102X",
            "taxonomy_group": "",
            "desc": "Pathology, Anatomic Pathology & Clinical Pathology",
            "state": "CA",
            "license": "G49163",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maximiliano Ruiz, LMFT
• Marcela Ruvalcaba
• Patrick J Ryan, MD
• Thomas Ryou
• Alan Saavedra
• Ana Maria Saez, ACSW
• Jessica Safaiyeh
• Amardeep K Sagoo, NP
• Lori Lynn Said
• Saint Gorge Radiology

• Anatomic Pathology & Clinical Pathology Physician in Sylmar, CA
• Providers in Sylmar, CA by specialty
• Anatomic Pathology & Clinical Pathology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.