Provider Demographics
NPI:1508991993
Name:SAKAMOTO, MICHAEL J (MD)
Entity Type:Individual
Prefix:
First Name:MICHAEL
Middle Name:J
Last Name:SAKAMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11216 TRINITY RIVER DR
Mailing Address - Street 2:
Mailing Address - City:RANCHO CORDOVA
Mailing Address - State:CA
Mailing Address - Zip Code:95670-2961
Mailing Address - Country:US
Mailing Address - Phone:916-635-6161
Mailing Address - Fax:916-631-3788
Practice Address - Street 1:11216 TRINITY RIVER DR
Practice Address - Street 2:
Practice Address - City:RANCHO CORDOVA
Practice Address - State:CA
Practice Address - Zip Code:95670-2961
Practice Address - Country:US
Practice Address - Phone:916-635-6161
Practice Address - Fax:916-631-3788
Is Sole Proprietor?:No
Enumeration Date:2007-02-23
Last Update Date:2011-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG60930207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G609300Medicaid
CA00G609300Medicare ID - Type Unspecified
CA00G609300Medicaid