MEDICARE: DR. SACHA Z. NIEMI 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	207Q00000X	Family Medicine Physician	0101239382	VA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	P00374863	OTHER		RR/MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	199505	OTHER	VA	ANTHEM
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1154359982
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SACHA Z. NIEMI MD

Provider Business Mailing Address
First Line	:	1580 VALENCIA ST
Second Line	:	SUITE 201
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4423
Country	:	US
Telephone Number	:	415-206-7541
Fax Number	:	415-550-6784

Provider Business Practice Location Address
First Line	:	1580 VALENCIA ST
Second Line	:	SUITE 201
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94110-4423
Country	:	US
Telephone Number	:	415-206-7541
Fax Number	:	415-550-6784

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

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/06/2014

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