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NPI Code Detail

MEDICARE: DR. MARC-ALAN IWAHASHI M.D.,

MEDICARE: DR. MARC-ALAN IWAHASHI M.D.,
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
1207Q00000XFamily Medicine PhysicianG68531CA

Other Identifiers

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

General Provider Information

NPI Number : 1235123985
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARC-ALAN IWAHASHI M.D.,
Provider Business Mailing Address
First Line : 20555 PROSPECT RD
Second Line : SUITE A
City : CUPERTINO
State : CA
Zip : 95014-5212
Country : US
Telephone Number : 408-253-5811
Fax Number : 408-725-0583
Provider Business Practice Location Address
First Line : 20555 PROSPECT RD
Second Line : SUITE A
City : CUPERTINO
State : CA
Zip : 95014-5212
Country : US
Telephone Number : 408-253-5811
Fax Number : 408-725-0583
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/08/2005
Last Update Date : 01/05/2012

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