Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | A97855 | CA |
N | 207RC0200X | Critical Care Medicine | A97855 | CA |
NPI | 1083758197 |
---|---|
Provider Name | Dr. Tsuyoshi Mitarai |
First Address | Palo Alto, CA 94304-1807 |
Second Address | Stanford, CA 94305-2200 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/02/2007 |
Last Update Date | 23/11/2019 |