Provider Demographics
NPI:1619579273
Name:SATO, SHIHO
Entity Type:Individual
Prefix:
First Name:SHIHO
Middle Name:
Last Name:SATO
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6701 ETON AVE APT 216
Mailing Address - Street 2:
Mailing Address - City:CANOGA PARK
Mailing Address - State:CA
Mailing Address - Zip Code:91303-4041
Mailing Address - Country:US
Mailing Address - Phone:818-447-3314
Mailing Address - Fax:
Practice Address - Street 1:6701 ETON AVE APT 216
Practice Address - Street 2:
Practice Address - City:CANOGA PARK
Practice Address - State:CA
Practice Address - Zip Code:91303-4041
Practice Address - Country:US
Practice Address - Phone:818-447-3314
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-09
Last Update Date:2020-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist