Provider Demographics
NPI:1316238124
Name:SAKO, ROY H
Entity type:Individual
Prefix:MR
First Name:ROY
Middle Name:H
Last Name:SAKO
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3570 SANTA ANITA AVE
Mailing Address - Street 2:
Mailing Address - City:EL MONTE
Mailing Address - State:CA
Mailing Address - Zip Code:91731-2456
Mailing Address - Country:US
Mailing Address - Phone:626-442-9238
Mailing Address - Fax:
Practice Address - Street 1:2024 SUMMER BLOSSOM CT UNIT 101
Practice Address - Street 2:
Practice Address - City:LAS VEGAS
Practice Address - State:NV
Practice Address - Zip Code:89134-2613
Practice Address - Country:US
Practice Address - Phone:626-277-1373
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-04-27
Last Update Date:2011-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA25109183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist