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Individual

FARRANT HIROSHI SAKAGUCHI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1525 W 2100 S, SALT LAKE CITY, UT 84119-1401
(801) 585-5393
Mailing address
127 S 500 E, SALT LAKE CITY, UT 84102-1959
(801) 587-6336

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7968365-1205
UT
207Q00000X
Family Medicine Physician
MR-0983
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
7968365-1205
UTAH PHYSICIAN AND SURGEON LICENSE
UT
01
M-10917
IDAHO STATE BOARD OF MEDICINE
ID
01
MR-0983
IDAHO STATE BOARD OF MEDICINE REGISTRATION
ID
Enumeration date
06/17/2008
Last updated
11/17/2021
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