Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 152W00000X | Optometrist | 14279 | CA |
NPI | 1013297944 |
---|---|
Provider Name | Dr. Kenzo Sean Otsuji |
First Address | Redondo Beach, CA 90277-6732 |
Second Address | Whittier, CA 90605-3228 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 23/08/2011 |
Last Update Date | 10/06/2021 |