MEDICARE: DR. CAROLE L SACHS OD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	4872TPA	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1205821741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CAROLE L SACHS OD

Provider Business Mailing Address
First Line	:	200 N BROADWAY
Second Line	:	SUITE E
City	:	TURLOCK
State	:	CA
Zip	:	95380-4744
Country	:	US
Telephone Number	:	209-667-1234
Fax Number	:	209-667-1234

Provider Business Practice Location Address
First Line	:	200 N BROADWAY
Second Line	:	SUITE E
City	:	TURLOCK
State	:	CA
Zip	:	95380-4744
Country	:	US
Telephone Number	:	209-667-1234
Fax Number	:	209-667-1234

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/12/2005
Last Update Date	:	09/03/2009

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