Provider Demographics
NPI:1114408176
Name:SACHS, MATTHEW TYLER (MS, RN, AGPCNP-BC)
Entity type:Individual
Prefix:
First Name:MATTHEW
Middle Name:TYLER
Last Name:SACHS
Suffix:
Gender:M
Credentials:MS, RN, AGPCNP-BC
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Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Mailing Address - Street 1:184 CARNELIAN WAY
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94131-1734
Mailing Address - Country:US
Mailing Address - Phone:415-602-5833
Mailing Address - Fax:
Practice Address - Street 1:222 W 39TH AVE
Practice Address - Street 2:
Practice Address - City:SAN MATEO
Practice Address - State:CA
Practice Address - Zip Code:94403-4364
Practice Address - Country:US
Practice Address - Phone:650-573-2385
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-27
Last Update Date:2018-08-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA95099023163W00000X
CA95009726363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care
No163W00000XNursing Service ProvidersRegistered Nurse