Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 59029 | CA |
NPI | 1013184035 |
---|---|
Provider Name | Erick Y Sato |
First Address | El Cajon, CA 92020-5207 |
Second Address | El Cajon, CA 92020-5207 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/05/2008 |
Last Update Date | 30/07/2012 |