MEDICARE: KARL L SACHS PSYD

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	103T00000X	Psychologist	3189	AZ

General Provider Information

NPI Number	:	1912993908
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL L SACHS PSYD

Provider Business Mailing Address
First Line	:	5210 E PIMA ST
Second Line	:	105 A
City	:	TUCSON
State	:	AZ
Zip	:	85712-3664
Country	:	US
Telephone Number	:	520-869-4166
Fax Number	:	520-795-3575

Provider Business Practice Location Address
First Line	:	5210 E PIMA ST
Second Line	:	SUITE 105 A
City	:	TUCSON
State	:	AZ
Zip	:	85712-3664
Country	:	US
Telephone Number	:	520-869-4166
Fax Number	:	520-795-3575

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

Provider Enumeration Date	:	09/23/2005
Last Update Date	:	10/25/2007

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