Provider Demographics
NPI:1457722548
Name:SAKOVER, MICHAEL
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:
Last Name:SAKOVER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9886 SCRIPPS WESTVIEW WAY
Mailing Address - Street 2:UNIT 181
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92131-2402
Mailing Address - Country:US
Mailing Address - Phone:619-804-2790
Mailing Address - Fax:
Practice Address - Street 1:9886 SCRIPPS WESTVIEW WAY
Practice Address - Street 2:UNIT 181
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92131-2402
Practice Address - Country:US
Practice Address - Phone:619-804-2790
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-14
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA14074225X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225X00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOccupational Therapist