MEDICARE: MRS. ROSARIO ODENA SAKAMOTO NP

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	363LA2200X	Adult Health Nurse Practitioner	NP 8894	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	:	1902805609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. ROSARIO ODENA SAKAMOTO NP

Provider Business Mailing Address
First Line	:	21402 AMBUSHERS ST
Second Line	:
City	:	DIAMOND BAR
State	:	CA
Zip	:	91765-3803
Country	:	US
Telephone Number	:	909-861-2987
Fax Number	:

Provider Business Practice Location Address
First Line	:	1201 S HACIENDA BLVD
Second Line	:
City	:	HACIENDA HEIGHTS
State	:	CA
Zip	:	91745-2200
Country	:	US
Telephone Number	:	626-968-0547
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/15/2005
Last Update Date	:	07/09/2007

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