Healthcare Provider Details

I. General information

NPI: 1033470760
Provider Name (Legal Business Name): NICOLAS SAWYER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/29/2012
Last Update Date: 09/16/2024
Certification Date: 09/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

347 ANDRIEUX ST
SONOMA CA
95476-6811
US

IV. Provider business mailing address

3631 TRUXEL RD # 1248
SACRAMENTO CA
95834-3604
US

V. Phone/Fax

Practice location:
  • Phone: 707-935-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number182876
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: