MEDICARE: DR. DEAN SARCO MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084N0400X	Neurology Physician	223493	MA
2	2084N0400X	Neurology Physician	A108749	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1124045901
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DEAN SARCO MD

Provider Business Mailing Address
First Line	:	1505 N EDGEMONT ST FL 5
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5209
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1505 N EDGEMONT ST FL 5
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90027-5209
Country	:	US
Telephone Number	:	800-954-8000
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/16/2006
Last Update Date	:	12/02/2021

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Directions to “ DR. DEAN SARCO MD” Practice Location

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