Provider Demographics
NPI:1134966641
Name:SAKOMED LLC
Entity type:Organization
Organization Name:SAKOMED LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:ADMINISTRATION
Authorized Official - Prefix:
Authorized Official - First Name:ADRIANA
Authorized Official - Middle Name:
Authorized Official - Last Name:PENALOZA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:714-322-7660
Mailing Address - Street 1:27751 LA PAZ RD STE A
Mailing Address - Street 2:
Mailing Address - City:LAGUNA NIGUEL
Mailing Address - State:CA
Mailing Address - Zip Code:92677-3939
Mailing Address - Country:US
Mailing Address - Phone:949-446-9216
Mailing Address - Fax:
Practice Address - Street 1:27751 LA PAZ RD STE A
Practice Address - Street 2:
Practice Address - City:LAGUNA NIGUEL
Practice Address - State:CA
Practice Address - Zip Code:92677-3939
Practice Address - Country:US
Practice Address - Phone:949-446-9216
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-11
Last Update Date:2024-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies