Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | G32450 | CA |
NPI | 1023028883 |
---|---|
Provider Name | Dr. Robert Michele Mochizuki |
First Address | Fresno, CA 93729-7708 |
Second Address | Fresno, CA 93720-3831 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/08/2006 |
Last Update Date | 08/08/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A45154 | (02) | CA |
P00611591 | RAILROAD MEDICARE (01) | CA |
ZZZ67459Z | BLUE SHIELD (01) | CA |