Individual
GAYLE KIKUMI SAKAGUCHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C, PTA
Contact information
Practice address
1600 W AVENUE J, LANCASTER, CA 93534-2814
(661) 949-5115
Mailing address
2139 W 166TH PL, TORRANCE, CA 90504-2244
(310) 538-2880
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
AT 1215
CA
363AM0700X
Medical Physician Assistant
Primary
PA 17174
CA
363AS0400X
Surgical Physician Assistant
PA 17174
CA
Other
Enumeration date
11/17/2006
Last updated
12/27/2023
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