Provider Demographics
NPI:1538684436
Name:SAITO, NATHAN YOSHIO
Entity Type:Individual
Prefix:
First Name:NATHAN
Middle Name:YOSHIO
Last Name:SAITO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1851 WOLVERTON AVE
Mailing Address - Street 2:
Mailing Address - City:CAMARILLO
Mailing Address - State:CA
Mailing Address - Zip Code:93010-3736
Mailing Address - Country:US
Mailing Address - Phone:805-889-3339
Mailing Address - Fax:
Practice Address - Street 1:1851 WOLVERTON AVE
Practice Address - Street 2:
Practice Address - City:CAMARILLO
Practice Address - State:CA
Practice Address - Zip Code:93010-3736
Practice Address - Country:US
Practice Address - Phone:805-889-3339
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-11
Last Update Date:2023-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293450225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist