Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207YP0228X | Pediatric Otolaryngology | A121951 | CA |
NPI | 1730400680 |
---|---|
Provider Name | Mika Sumiyoshi |
First Address | Sacramento, CA 95817-2207 |
Second Address | Sacramento, CA 95817-2207 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2010 |
Last Update Date | 28/06/2016 |