Healthcare Provider Details

I. General information

NPI: 1548883382
Provider Name (Legal Business Name): TAKUMI KAWASHITA DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/27/2020
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

400 N PEPPER AVE
COLTON CA
92324-1801
US

IV. Provider business mailing address

615 E 3RD ST
POMONA CA
91766-1906
US

V. Phone/Fax

Practice location:
  • Phone: 909-580-6343
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number20A22563
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: