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Individual

MARK J SADA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD, FACC

Contact information

Practice address
1941 JOHNSON AVE, STE 101, SAN LUIS OBISPO, CA 93401-4154
(805) 782-8844
(805) 782-8859
Mailing address
1941 JOHNSON AVE, STE 101, SAN LUIS OBISPO, CA 93401-4154
(805) 782-8844
(805) 782-8859

Taxonomy

Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
G69997
CA
207RI0011X
Interventional Cardiology Physician
Primary
G69997
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G699970
CA
01
990003291
RR MEDI-CARE
CA
01
ZZZ28458Z
BLUE SHIELD
CA
Enumeration date
01/04/2006
Last updated
10/14/2024
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