Provider Demographics
NPI:1710260666
Name:SAGUTO, LIZA
Entity Type:Individual
Prefix:DR
First Name:LIZA
Middle Name:
Last Name:SAGUTO
Suffix:
Gender:F
Credentials:
Other - Prefix:DR
Other - First Name:LIZA
Other - Middle Name:
Other - Last Name:SAGUTO
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:PO BOX 8843
Mailing Address - Street 2:
Mailing Address - City:GOLETA
Mailing Address - State:CA
Mailing Address - Zip Code:93118-8843
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5900 CALLE REAL
Practice Address - Street 2:
Practice Address - City:GOLETA
Practice Address - State:CA
Practice Address - Zip Code:93117-2312
Practice Address - Country:US
Practice Address - Phone:805-967-3798
Practice Address - Fax:805-967-3798
Is Sole Proprietor?:No
Enumeration Date:2011-09-27
Last Update Date:2011-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA54140183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist