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NPI Code Detail

MEDICARE: SHARON SATSUKI ITAYA MD

MEDICARE: SHARON SATSUKI ITAYA MD
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
1207R00000XInternal Medicine PhysicianF7789TX

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2513708YLPSOTHERWELLMED MEDICAL GROUP

General Provider Information

NPI Number : 1386698850
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARON SATSUKI ITAYA MD
Provider Business Mailing Address
First Line : 15 WALLER ST
Second Line : ATTN: FINANCE, 5TH FLOOR
City : AUSTIN
State : TX
Zip : 78702-5240
Country : US
Telephone Number : 572-978-9000
Fax Number : 572-978-9001
Provider Business Practice Location Address
First Line : 2529 S 1ST ST
Second Line : SOUTH AUSTIN COMMUNITY HEALTH CENTER
City : AUSTIN
State : TX
Zip : 78704-5466
Country : US
Telephone Number : 572-972-4722
Fax Number : 572-972-4708
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/20/2006
Last Update Date : 07/27/2016

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