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General NPI Number Information
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NPI Number | 1184830713
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Entity Type | Individual
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Provider Name | GERALD LEE SAKS M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/14/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 5700 ARLINGTON AVE
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City | RIVERSIDE
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State | CA
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Zip | 92504-2035
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Country | US
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Telephone | 951-274-4213
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Fax | 951-274-4203
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Provider Business Mailing Address
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Address Line | 5929 INTERVALE DR
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City | RIVERSIDE
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State | CA
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Zip | 92506-4050
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Country | US
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Telephone |
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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 | 261QS1000X
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Taxonomy Name | Student Health Clinic/Center
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License Number | G9945
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License Number State | CA
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