Healthcare Provider Details

I. General information

NPI: 1265577423
Provider Name (Legal Business Name): DRS. TAKAHASHI & SAKAZAKI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/21/2007
Last Update Date: 02/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 O ST STE 102
SACRAMENTO CA
95814-5327
US

IV. Provider business mailing address

400 O ST STE 102
SACRAMENTO CA
95814-5327
US

V. Phone/Fax

Practice location:
  • Phone: 916-443-3524
  • Fax: 916-443-3986
Mailing address:
  • Phone: 916-443-3524
  • Fax: 916-443-3986

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code332H00000X
TaxonomyEyewear Supplier
License Number
License Number State

VIII. Authorized Official

Name: MRS. JENNIFER L SAKAZAKI
Title or Position: OFFICE MANAGER
Credential:
Phone: 916-443-3524