Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | G66772 | CA |
NPI | 1013940535 |
---|---|
Provider Name | Joan T Sasaki |
First Address | Mission Viejo, CA 92691-6329 |
Second Address | Mission Viejo, CA 92691-6329 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2006 |
Last Update Date | 10/02/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F51360 | (02) | CA |