Provider Demographics
NPI:1063427524
Name:SATO, NAOMI (MD)
Entity type:Individual
Prefix:
First Name:NAOMI
Middle Name:
Last Name:SATO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 FLORIN ROAD
Mailing Address - Street 2:SUITE #B
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95831-3501
Mailing Address - Country:US
Mailing Address - Phone:916-421-8245
Mailing Address - Fax:916-421-9571
Practice Address - Street 1:900 FLORIN ROAD
Practice Address - Street 2:SUITE #B
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95831-3501
Practice Address - Country:US
Practice Address - Phone:916-421-8245
Practice Address - Fax:916-421-9571
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-30
Last Update Date:2011-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG46133208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAOOG461330Medicaid
F09903Medicare UPIN