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NPI Code Detail

MEDICARE: DR. THOMAS HIROSHI OKAMOTO M.D.

MEDICARE: DR. THOMAS HIROSHI OKAMOTO 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
12084P0800XPsychiatry PhysicianG48164CA

General Provider Information

NPI Number : 1235178021
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS HIROSHI OKAMOTO M.D.
Provider Business Mailing Address
First Line : 2130 E 4TH ST
Second Line : SUITE 107
City : SANTA ANA
State : CA
Zip : 92705-3818
Country : US
Telephone Number : 714-558-2460
Fax Number : 714-972-0275
Provider Business Practice Location Address
First Line : 2130 E 4TH ST
Second Line : SUITE 107
City : SANTA ANA
State : CA
Zip : 92705-3818
Country : US
Telephone Number : 714-558-2460
Fax Number : 714-972-0275
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/06/2006
Last Update Date : 06/30/2009

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