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General NPI Number Information
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NPI Number | 1295913770
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Entity Type | Individual
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Provider Name | AYAKA SATO O.D.
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Gender | Female
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Dates
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Enumeration Date | 02/06/2008
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Last Update Date | 02/25/2016
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Provider Practice Location Address
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Address Line | 1141 W REDONDO BEACH BLVD
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City | GARDENA
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State | CA
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Zip | 90247-3586
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Country | US
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Telephone | 310-767-7814
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Fax |
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Provider Business Mailing Address
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Address Line | 1141 W REDONDO BEACH BLVD STE 101
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City | GARDENA
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State | CA
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Zip | 90247-3585
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Country | US
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Telephone | 310-767-7814
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Fax | 310-323-3785
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 0618001703
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License Number State | VA
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Taxonomy #2
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 14212
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 771
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License Number State | HI
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