Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 111NN0400X | Neurology | 21817 | CA |
N | 111NS0005X | Chiropractic Sports Physician | 21817 | CA |
NPI | 1235357336 |
---|---|
Provider Name | Dr. Hiro Sugawara |
First Address | Sunnyvale, CA 94087-3065 |
Second Address | Sunnyvale, CA 94087-3065 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/04/2007 |
Last Update Date | 08/07/2007 |