Provider Demographics
NPI:1245339704
Name:DR AARON M SAKO A PROFESSIONAL OPTOMETRIC CORP
Entity type:Organization
Organization Name:DR AARON M SAKO A PROFESSIONAL OPTOMETRIC CORP
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AARON
Authorized Official - Middle Name:M
Authorized Official - Last Name:SAKO
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:949-586-8200
Mailing Address - Street 1:25252 MCINTYRE ST
Mailing Address - Street 2:SUITE D
Mailing Address - City:LAGUNA HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:92653-5448
Mailing Address - Country:US
Mailing Address - Phone:949-586-8200
Mailing Address - Fax:949-586-1538
Practice Address - Street 1:25252 MCINTYRE ST
Practice Address - Street 2:SUITE D
Practice Address - City:LAGUNA HILLS
Practice Address - State:CA
Practice Address - Zip Code:92653-5448
Practice Address - Country:US
Practice Address - Phone:949-586-8200
Practice Address - Fax:949-586-1538
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-21
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CACO937AMedicare PIN