Provider Demographics
NPI:1851755508
Name:KANAMORI, SARA MURASAKI
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:MURASAKI
Last Name:KANAMORI
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20911 EARL ST STE 280
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4354
Mailing Address - Country:US
Mailing Address - Phone:424-409-5080
Mailing Address - Fax:
Practice Address - Street 1:20911 EARL ST STE 280
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4354
Practice Address - Country:US
Practice Address - Phone:424-409-5080
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-04-08
Last Update Date:2020-10-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY306243207R00000X
CA18484207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine