Basic Information
| Provider Information | |||||||||
| NPI: | 1518011576 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | JOHN SASAKI MD INC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 129 | ||||||||
| Address2: | |||||||||
| City: | CLAREMONT | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917110129 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094500377 | ||||||||
| FaxNumber: | 9094500356 | ||||||||
| Practice Location | |||||||||
| Address1: | 255 E BONITA AVE | ||||||||
| Address2: | BLDG 1A | ||||||||
| City: | POMONA | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917671923 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9094500377 | ||||||||
| FaxNumber: | 9094500356 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/23/2007 | ||||||||
| LastUpdateDate: | 04/08/2009 | ||||||||
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| AuthorizedOfficialLastName: | CYR | ||||||||
| AuthorizedOfficialFirstName: | DOUGLAS | ||||||||
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| AuthorizedOfficialTitleorPosition: | BILLING ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 8189572192 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207LP2900X | G45473 | CA | Y | 193400000X MULTIPLE SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Anesthesiology | Pain Medicine |
No ID Information.