Provider Demographics
NPI:1942233390
Name:KENNETH K. SAKAMOTO M.D., INC.
Entity Type:Organization
Organization Name:KENNETH K. SAKAMOTO M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:KENJI
Authorized Official - Last Name:SAKAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-792-8916
Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 530
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4504
Mailing Address - Country:US
Mailing Address - Phone:310-792-8916
Mailing Address - Fax:310-792-8919
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 530
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-792-8916
Practice Address - Fax:310-792-8919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
W18021Medicare ID - Type Unspecified