Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2086X0206X | Surgical Oncologist | A110892 | CA |
NPI | 1174888937 |
---|---|
Provider Name | Dr. Manabu Fujita |
First Address | Thousand Oaks, CA 91360-4236 |
Second Address | Thousand Oaks, CA 91360-4236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/07/2012 |
Last Update Date | 13/07/2014 |