Healthcare Provider Details

I. General information

NPI: 1114731643
Provider Name (Legal Business Name): YUKIKO KOBORI NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/05/2025
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3450 WILSHIRE BLVD STE 1118
LOS ANGELES CA
90010-2227
US

IV. Provider business mailing address

3450 WILSHIRE BLVD STE 1118
LOS ANGELES CA
90010-2227
US

V. Phone/Fax

Practice location:
  • Phone: 213-468-4548
  • Fax:
Mailing address:
  • Phone: 213-468-4548
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberNP95030045
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: