Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | G76844 | CA |
NPI | 1003872599 |
---|---|
Provider Name | Dr. Jeffrey Koji Sakihara |
First Address | San Diego, CA 92123-1810 |
Second Address | San Diego, CA 92123-1810 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2006 |
Last Update Date | 10/08/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G768440 | (05) | CA |
G12529 | (02) | CA |