Healthcare Provider Details

I. General information

NPI: 1811041148
Provider Name (Legal Business Name): NANCY L. SACHSEL PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/23/2007
Last Update Date: 06/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7317 CENTRAL AVE NE
ALBUQUERQUE NM
87108-2015
US

IV. Provider business mailing address

200 OCEANGATE SUIT 100
LONG BEACH CA
90802-4317
US

V. Phone/Fax

Practice location:
  • Phone: 505-200-3320
  • Fax: 877-860-2279
Mailing address:
  • Phone: 505-200-3320
  • Fax: 877-860-2279

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number63
License Number StateCO
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number63
License Number StateCO
# 3
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA2011-0055
License Number StateNM

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: