| Mimi K. Sato-re, Md Medical Corporation | |
|
1600 Creekside Dr Suite 3300 Folsom CA 95630-3444 | |
| (916) 983-7200 | |
| (916) 983-8591 |
| Full Name | Mimi K. Sato-re, Md Medical Corporation |
|---|---|
| Speciality | Clinic/Center |
| Location | 1600 Creekside Dr, Folsom, California |
| Authorized Official Name and Position | Mimi Kiyoko Sato-re (OWNER) |
| Authorized Official Contact | 9169837200 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mimi K. Sato-re, Md Medical Corporation 1600 Creekside Dr Suite 3300 Folsom CA 95630-3444 Ph: (916) 983-7200 | Mimi K. Sato-re, Md Medical Corporation 1600 Creekside Dr Suite 3300 Folsom CA 95630-3444 Ph: (916) 983-7200 |
| NPI Number | 1699945063 |
|---|---|
| Provider Enumeration Date | 03/02/2008 |
| Last Update Date | 04/02/2008 |
| Medicare PECOS PAC ID | 0648544882 |
|---|---|
| Medicare Enrollment ID | O20170926003969 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699945063 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | A61185 (California) | Primary |
| Provider Name | Mimi K Sato-re |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1649372921 PECOS PAC ID: 2062418163 Enrollment ID: I20061012000613 |
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