Provider Demographics
NPI:1326490475
Name:SASAKI MEDICAL LLC
Entity Type:Organization
Organization Name:SASAKI MEDICAL LLC
Other - Org Name:KAI SHIN CLINIC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALANA
Authorized Official - Middle Name:KIM
Authorized Official - Last Name:SASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:651-447-3755
Mailing Address - Street 1:777 RAYMOND AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55114-1522
Mailing Address - Country:US
Mailing Address - Phone:651-447-3755
Mailing Address - Fax:
Practice Address - Street 1:2233 HAMLINE AVE N
Practice Address - Street 2:STE 110
Practice Address - City:ROSEVILLE
Practice Address - State:MN
Practice Address - Zip Code:55113-5009
Practice Address - Country:US
Practice Address - Phone:651-447-3755
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-07-12
Last Update Date:2024-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207QA0401XAllopathic & Osteopathic PhysiciansFamily MedicineAddiction MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care