Provider Demographics
NPI:1871566554
Name:SAKAMOTO, DOUGLAS (MD)
Entity type:Individual
Prefix:
First Name:DOUGLAS
Middle Name:
Last Name:SAKAMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:23609 HAWTHORNE BLVD STE A
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-6023
Mailing Address - Country:US
Mailing Address - Phone:310-378-7474
Mailing Address - Fax:310-378-5454
Practice Address - Street 1:23609 HAWTHORNE BLVD STE A
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-6023
Practice Address - Country:US
Practice Address - Phone:310-378-7474
Practice Address - Fax:310-378-5454
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-10
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA87145207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI16463Medicare UPIN