Provider Demographics
NPI:1154659357
Name:AARON T. SASAKI, MD, PC
Entity type:Organization
Organization Name:AARON T. SASAKI, MD, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:AARON
Authorized Official - Middle Name:T
Authorized Official - Last Name:SASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:503-338-4325
Mailing Address - Street 1:2095 EXCHANGE ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-3417
Mailing Address - Country:US
Mailing Address - Phone:503-338-4325
Mailing Address - Fax:503-338-2903
Practice Address - Street 1:2095 EXCHANGE ST
Practice Address - Street 2:SUITE 202
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-3417
Practice Address - Country:US
Practice Address - Phone:503-338-4325
Practice Address - Fax:503-338-2903
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-11-27
Last Update Date:2011-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD26759207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty