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NPI Code Detail

MEDICARE: JOHN M. ITAMURA MD

MEDICARE: JOHN M. ITAMURA MD
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207X00000XOrthopaedic Surgery PhysicianG69735CA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200G697350OTHERCABLUE SHIELD

General Provider Information

NPI Number : 1164476719
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN M. ITAMURA MD
Provider Business Mailing Address
First Line : 6801 PARK TER
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-1543
Country : US
Telephone Number : 310-665-7200
Fax Number :
Provider Business Practice Location Address
First Line : 301 N LAKE AVE STE 201
Second Line :
City : PASADENA
State : CA
Zip : 91101-5120
Country : US
Telephone Number : 626-568-9030
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/19/2006
Last Update Date : 02/09/2021

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Directions to “ JOHN M. ITAMURA MD” Practice Location

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