Provider Demographics
NPI:1093886350
Name:SAKODA, MARC TODD (DC)
Entity Type:Individual
Prefix:DR
First Name:MARC
Middle Name:TODD
Last Name:SAKODA
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:32395 CLINTON KEITH RD
Mailing Address - Street 2:SUITE 104
Mailing Address - City:WILDOMAR
Mailing Address - State:CA
Mailing Address - Zip Code:92595-8508
Mailing Address - Country:US
Mailing Address - Phone:951-678-9063
Mailing Address - Fax:951-678-2893
Practice Address - Street 1:32395 CLINTON KEITH RD
Practice Address - Street 2:SUITE 104
Practice Address - City:WILDOMAR
Practice Address - State:CA
Practice Address - Zip Code:92595-8508
Practice Address - Country:US
Practice Address - Phone:951-678-9063
Practice Address - Fax:951-678-2893
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CADC26808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
CADC26808Medicare ID - Type Unspecified