Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0004X | Dentist Anesthesiologist | 1174 | CA |
N | 1223G0001X | General Practice | D44339 | CA |
N | 213EG0000X | General Practice | D44339 | CA |
NPI | 1700972171 |
---|---|
Provider Name | Ms. Katsuko Matsui |
First Address | Loma Linda, CA 92354-6701 |
Second Address | Cypress, CA 90630-3156 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/10/2006 |
Last Update Date | 28/05/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1699906586 | (05) | CA |