# BAYSIDE ANESTHESIA MEDICAL GROUP

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1184668469
- **Authorized official:** DR. KENNETH R. SACKS M.D. (PARTNER)
- **Authorized official phone:** (310) 440-3131

## Contact information

- **Practice address:** 2121 SANTA MONICA BLVD, SANTA MONICA, CA 90404-2303
- **Practice address phone:** (310) 576-7267
- **Mailing address:** PO BOX 60790, PASADENA, CA 91116-6790
- **Mailing address phone:** (626) 795-6596
- **Mailing address fax:** (626) 795-8247

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | NULL | Yes |
| 207LP2900X | Pain Medicine (Anesthesiology) Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/16/2006
- **Last updated:** 04/03/2025