MEDICARE: DR. GREG MICHIRO HIROKAWA PH.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
1	103TC0700X	Clinical Psychologist	PSY14394	CA

General Provider Information

NPI Number	:	1558424887
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GREG MICHIRO HIROKAWA PH.D.

Provider Business Mailing Address
First Line	:	PO BOX 2152
Second Line	:
City	:	DELANO
State	:	CA
Zip	:	93216-2152
Country	:	US
Telephone Number	:	661-725-6365
Fax Number	:

Provider Business Practice Location Address
First Line	:	4900 CALIFORNIA AVE
Second Line	:	SUITE 210B
City	:	BAKERSFIELD
State	:	CA
Zip	:	93309-7024
Country	:	US
Telephone Number	:	661-725-6365
Fax Number	:	661-725-1008

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/18/2006
Last Update Date	:	12/02/2016

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