Healthcare Provider Details

I. General information

NPI: 1982911624
Provider Name (Legal Business Name): HIROKI NARIAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2010
Last Update Date: 09/15/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

757 WESTWOOD PLZ
LOS ANGELES CA
90095-2401
US

IV. Provider business mailing address

10833 LE CONTE AVE RM 22-474
LOS ANGELES CA
90095-2401
US

V. Phone/Fax

Practice location:
  • Phone: 310-825-9111
  • Fax:
Mailing address:
  • Phone: 310-825-6196
  • Fax: 310-825-5834

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number4301093987
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberNA
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code2084N0402X
TaxonomyNeurology with Special Qualifications in Child Neurology Physician
License NumberA136872
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: