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General NPI Number Information
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NPI Number | 1114408176
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Entity Type | Individual
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Provider Name | MATTHEW TYLER SACHS MS, RN, AGPCNP-BC
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Gender | Male
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Dates
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Enumeration Date | 08/27/2018
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Last Update Date | 08/27/2018
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Provider Practice Location Address
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Address Line | 222 W 39TH AVE
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City | SAN MATEO
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State | CA
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Zip | 94403-4364
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Country | US
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Telephone | 650-573-2385
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Fax |
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Provider Business Mailing Address
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Address Line | 184 CARNELIAN WAY
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City | SAN FRANCISCO
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State | CA
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Zip | 94131-1734
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Country | US
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Telephone | 415-602-5833
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 95009726
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 95099023
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License Number State | CA
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