Individual
MR. KENNETH R. SACKS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1328 22ND ST, SANTA MONICA, CA 90404-2032
(310) 829-8202
Mailing address
225 S LAKE AVE, #535, PASADENA, CA 91101-3005
(626) 795-6596
(626) 795-8247
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G61776
CA
Other
Enumeration date
08/30/2006
Last updated
01/28/2014
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