MEDICARE: SAKAYE SHIGEKAWA M.D.

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	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	A09493	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891764304
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SAKAYE SHIGEKAWA M.D.

Provider Business Mailing Address
First Line	:	1511 N BENTON WAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-2218
Country	:	US
Telephone Number	:	213-413-3115
Fax Number	:	310-545-0871

Provider Business Practice Location Address
First Line	:	1511 N BENTON WAY
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90026-2218
Country	:	US
Telephone Number	:	213-413-3115
Fax Number	:	310-545-0871

Authorized Official
Title or Position	:	OWNER
Name	:	DR. SAKAYE SHIGEKAWA
Credential	:	M.D.
Telephone Number	:	213-413-3115

Provider Enumeration Date	:	03/16/2006
Last Update Date	:	08/22/2020

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