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Individual

KEN SODERLUND SATO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
352 ALTA AVE, SANTA CRUZ, CA 95060-6442
(831) 401-2313
(831) 401-2313
Mailing address
849 ALMAR AVE, SUITE C, #169, SANTA CRUZ, CA 95060-5875
(831) 401-2313

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
10583
HI
207T00000X
Neurological Surgery Physician
Primary
G85728
CA
207T00000X
Neurological Surgery Physician
MD24401
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00G857280
CA
05
297482
OR
Enumeration date
10/14/2005
Last updated
04/07/2010
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