Provider Demographics
NPI:1043434301
Name:SAEKAN, CEDRIC A
Entity type:Individual
Prefix:
First Name:CEDRIC
Middle Name:A
Last Name:SAEKAN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:82563 BARI LN
Mailing Address - Street 2:
Mailing Address - City:INDIO
Mailing Address - State:CA
Mailing Address - Zip Code:92203-3123
Mailing Address - Country:US
Mailing Address - Phone:760-272-9817
Mailing Address - Fax:
Practice Address - Street 1:82563 BARI LN
Practice Address - Street 2:
Practice Address - City:INDIO
Practice Address - State:CA
Practice Address - Zip Code:92203-3123
Practice Address - Country:US
Practice Address - Phone:760-272-9817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2017-01-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAHA6022237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist