Provider Demographics
NPI:1750728259
Name:SAKAI, MASANAO RUSSELL (PHARMD)
Entity type:Individual
Prefix:
First Name:MASANAO
Middle Name:RUSSELL
Last Name:SAKAI
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:RUSSELL
Other - Middle Name:
Other - Last Name:SAKAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:3125 EL CAPITAN AVE
Mailing Address - Street 2:
Mailing Address - City:MERCED
Mailing Address - State:CA
Mailing Address - Zip Code:95340-1403
Mailing Address - Country:US
Mailing Address - Phone:209-769-4214
Mailing Address - Fax:
Practice Address - Street 1:737 W CHILDS AVE
Practice Address - Street 2:
Practice Address - City:MERCED
Practice Address - State:CA
Practice Address - Zip Code:95341-6805
Practice Address - Country:US
Practice Address - Phone:209-383-1848
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-24
Last Update Date:2013-05-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CARPH331081835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy