MEDICARE: MR. ROY H SAKO

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	25109	CA

General Provider Information

NPI Number	:	1316238124
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. ROY H SAKO

Provider Business Mailing Address
First Line	:	3570 SANTA ANITA AVE
Second Line	:
City	:	EL MONTE
State	:	CA
Zip	:	91731-2456
Country	:	US
Telephone Number	:	626-442-9238
Fax Number	:

Provider Business Practice Location Address
First Line	:	2024 SUMMER BLOSSOM CT UNIT 101
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89134-2613
Country	:	US
Telephone Number	:	626-277-1373
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/27/2011
Last Update Date	:	04/27/2011

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