Healthcare Provider Details

I. General information

NPI: 1275622748
Provider Name (Legal Business Name): THOMAS G HIROSE MD APC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/12/2006
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

24407 CALLE DE LA LOUISA STE 100
LAGUNA HILLS CA
92653-3650
US

IV. Provider business mailing address

24407 CALLE DE LA LOUISA STE 100
LAGUNA HILLS CA
92653-3650
US

V. Phone/Fax

Practice location:
  • Phone: 310-373-5700
  • Fax: 949-581-7555
Mailing address:
  • Phone: 310-373-5700
  • Fax: 949-581-7555

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207ZB0001X
TaxonomyBlood Banking & Transfusion Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207ZP0102X
TaxonomyAnatomic Pathology & Clinical Pathology Physician
License Number
License Number State

VIII. Authorized Official

Name: MS. SANDRA CRAMER
Title or Position: PRACTICE MANAGER
Credential:
Phone: 949-581-0555