Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XX0005X | Sports Medicine Orthopaedic Surgeon | A116074 | CA |
NPI | 1235391798 |
---|---|
Provider Name | Dr. Scott Koji Fujii |
First Address | Carmichael, CA 95608-0363 |
Second Address | Carmichael, CA 95608-0363 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 30/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4292600001 | DME SUPPLIER NUMBER (01) | CA |
A116074 | CA PHYSICIAN/SURGEON LICENSE (01) |