Provider Demographics
NPI:1700049350
Name:SAKAI, KIMBERLEE ITSUKO (OD)
Entity Type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:ITSUKO
Last Name:SAKAI
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:730 SPAANS DR STE A
Mailing Address - Street 2:
Mailing Address - City:GALT
Mailing Address - State:CA
Mailing Address - Zip Code:95632-8611
Mailing Address - Country:US
Mailing Address - Phone:209-745-2880
Mailing Address - Fax:209-745-6840
Practice Address - Street 1:730 SPAANS DR STE A
Practice Address - Street 2:
Practice Address - City:GALT
Practice Address - State:CA
Practice Address - Zip Code:95632-8611
Practice Address - Country:US
Practice Address - Phone:209-745-2880
Practice Address - Fax:209-745-6840
Is Sole Proprietor?:No
Enumeration Date:2008-07-03
Last Update Date:2024-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG002104152W00000X
CA13552T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist