Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204C00000X | Sports Medicine Doctor | A025065 | CA |
NPI | 1538276746 |
---|---|
Provider Name | Dr. Tsuneo Hirabayashi |
First Address | Torrance, CA 90505-3052 |
Second Address | Torrance, CA 90505-3052 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/08/2006 |
Last Update Date | 09/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
A83170 | (02) | CA |