Individual
MS. LEA KIKU MATSUOKA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2335 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(310) 989-1806
Mailing address
2335 STOCKTON BLVD, SACRAMENTO, CA 95817-2201
(310) 989-1806
Taxonomy
Speciality
Code
Description
License number
State
204F00000X
Transplant Surgery Physician
56163
TN
204F00000X
Transplant Surgery Physician
Primary
A86822
CA
208600000X
Surgery Physician
A86822
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A868220
BLUE SHIELD PROVIDER NUMBER
CA
05
—
00A868220
—
CA
Enumeration date
03/01/2008
Last updated
05/22/2023
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