Healthcare Provider Details

I. General information

NPI: 1699319418
Provider Name (Legal Business Name): SACHA NIEMI A MEDICAL CORPORATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/05/2019
Last Update Date: 05/25/2021
Certification Date: 05/25/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

751 SAN PEDRO TERRACE RD
PACIFICA CA
94044-4101
US

IV. Provider business mailing address

26 CAMEO WAY
SAN FRANCISCO CA
94131-1634
US

V. Phone/Fax

Practice location:
  • Phone: 415-233-1099
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. SACHA Z NIEMI
Title or Position: CEO
Credential: MD
Phone: 415-223-1099