Provider Demographics
NPI:1568626331
Name:SATO, ALISA K (MD)
Entity Type:Individual
Prefix:DR
First Name:ALISA
Middle Name:K
Last Name:SATO
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:12401 WASHINGTON BOULEVARD
Mailing Address - Street 2:INTERCOMMUNITY EMERGENCY MEDICINE GROUP (IEMG)
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90602
Mailing Address - Country:US
Mailing Address - Phone:562-698-0811
Mailing Address - Fax:562-945-5283
Practice Address - Street 1:12401 WASHINGTON BOULEVARD
Practice Address - Street 2:INTERCOMMUNITY EMERGENCY MEDICINE GROUP (IEMG)
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90602
Practice Address - Country:US
Practice Address - Phone:562-698-0811
Practice Address - Fax:310-782-1763
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-10
Last Update Date:2012-09-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
390200000X
CAA109328207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program