Provider Demographics
NPI:1154319002
Name:SASAKA, KAORU (MD)
Entity Type:Individual
Prefix:
First Name:KAORU
Middle Name:
Last Name:SASAKA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DRIVE
Mailing Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS DEPT RADIOLOGY
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1082
Mailing Address - Country:US
Mailing Address - Phone:319-356-7222
Mailing Address - Fax:319-356-2220
Practice Address - Street 1:200 HAWKINS DRIVE
Practice Address - Street 2:UNIVERSITY OF IOWA HOSPITALS & CLINICS DEPT RADIOLOGY
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1082
Practice Address - Country:US
Practice Address - Phone:319-356-7222
Practice Address - Fax:319-356-2220
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-10-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IASP1562085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA0442293Medicaid
IA36839OtherWELLMARK BCBS
IA36839OtherWELLMARK BCBS
IA0442293Medicaid