Healthcare Provider Details

I. General information

NPI: 1770468423
Provider Name (Legal Business Name): YUTO USUI
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/11/2025
Last Update Date: 08/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2605 CARLSBAD BLVD
CARLSBAD CA
92008
US

IV. Provider business mailing address

7920 DONZEE ST.
SAN DIEGO CA
92123
US

V. Phone/Fax

Practice location:
  • Phone: 760-729-2385
  • Fax:
Mailing address:
  • Phone: 619-298-4123
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: