Healthcare Provider Details

I. General information

NPI: 1285557272
Provider Name (Legal Business Name): MASAAKI ALEXANDER KAMIYA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/04/2026
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1230 ROSECRANS AVE STE 300
MANHATTAN BEACH CA
90266-2494
US

IV. Provider business mailing address

1230 ROSECRANS AVE STE 300
MANHATTAN BEACH CA
90266-2494
US

V. Phone/Fax

Practice location:
  • Phone: 213-222-8402
  • Fax:
Mailing address:
  • Phone: 213-222-8402
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number139946
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: