Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208200000X | Surgeon | 282373 | NY |
N | 208600000X | Surgeon | 282373 | NY |
N | 2086X0206X | Surgical Oncologist | 282373 | NY |
Y | 2086X0206X | Surgical Oncologist | C175446 | CA |
NPI | 1386609584 |
---|---|
Provider Name | Fumito Ito |
First Address | Los Angeles, CA 90031-0309 |
Second Address | Los Angeles, CA 90033-5331 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 19/04/2006 |
Last Update Date | 29/11/2021 |