Healthcare Provider Details

I. General information

NPI: 1326786567
Provider Name (Legal Business Name): RYAN M. SADAKANE D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2022
Last Update Date: 09/11/2025
Certification Date: 09/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27924 SECO CANYON ROAD
SANTA CLARITA CA
91350-3870
US

IV. Provider business mailing address

PO BOX 9602
MISSION HILLS CA
91346-9602
US

V. Phone/Fax

Practice location:
  • Phone: 661-513-2132
  • Fax: 661-513-2100
Mailing address:
  • Phone: 213-394-7921
  • Fax: 509-627-2983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number20A24061
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24061
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: