Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN1001X | Nutrition | 18101 | CA |
NPI | 1417148776 |
---|---|
Provider Name | Dr. Kevin Mitchell Hamasaki |
First Address | Los Angeles, CA 90016-5726 |
Second Address | Los Angeles, CA 90016-5726 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2007 |
Last Update Date | 11/08/2016 |