Provider Demographics
NPI:1144680695
Name:REID SASAKI MD INC
Entity type:Organization
Organization Name:REID SASAKI MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:REID
Authorized Official - Middle Name:
Authorized Official - Last Name:SASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:858-522-0427
Mailing Address - Street 1:5663 BALBOA AVE UNIT 463
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92111-2705
Mailing Address - Country:US
Mailing Address - Phone:858-522-0427
Mailing Address - Fax:
Practice Address - Street 1:5663 BALBOA AVE UNIT 463
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92111-2705
Practice Address - Country:US
Practice Address - Phone:858-522-0427
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-02-25
Last Update Date:2016-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA112780282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital