Provider Demographics
NPI:1215250824
Name:OSATO MEDICAL CLINIC, INC
Entity type:Organization
Organization Name:OSATO MEDICAL CLINIC, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/ PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MASAHARU
Authorized Official - Middle Name:MIKE
Authorized Official - Last Name:OSATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-534-8200
Mailing Address - Street 1:3440 LOMITA BLVD
Mailing Address - Street 2:SUITE 320
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-4801
Mailing Address - Country:US
Mailing Address - Phone:310-534-8200
Mailing Address - Fax:310-534-8265
Practice Address - Street 1:3440 LOMITA BLVD
Practice Address - Street 2:SUITE 320
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-4801
Practice Address - Country:US
Practice Address - Phone:310-534-8200
Practice Address - Fax:310-534-8265
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-10
Last Update Date:2010-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP18903261QH0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service