Provider Demographics
NPI:1255679445
Name:SAKAMOTO, EDWIN KENJI (MD)
Entity Type:Individual
Prefix:DR
First Name:EDWIN
Middle Name:KENJI
Last Name:SAKAMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:5995 PLAZA DR.
Mailing Address - Street 2:MAIL STOP CA112-0533
Mailing Address - City:CYPRESS
Mailing Address - State:CA
Mailing Address - Zip Code:90630-5015
Mailing Address - Country:US
Mailing Address - Phone:714-226-3762
Mailing Address - Fax:714-226-3933
Practice Address - Street 1:5995 PLAZA DR.
Practice Address - Street 2:MAIL STOP CA112-0533
Practice Address - City:CYPRESS
Practice Address - State:CA
Practice Address - Zip Code:90630-5015
Practice Address - Country:US
Practice Address - Phone:714-226-3762
Practice Address - Fax:714-226-3933
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-22
Last Update Date:2013-01-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG30948207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine