Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | G85003 | CA |
Y | 207XS0106X | Orthopaedic Hand Surgeon | G85003 | CA |
NPI | 1316050594 |
---|---|
Provider Name | Michael Francis Sacco |
First Address | Walnut Creek, CA 94598-8396 |
Second Address | Concord, CA 94520 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/08/2006 |
Last Update Date | 17/09/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
200043108 | RAILROAD MEDICARE (01) | |
CA185052 | MEDICARE PTAN (01) | CA |
G76391 | (02) |