Healthcare Provider Details

I. General information

NPI: 1558491480
Provider Name (Legal Business Name): YASUKO FURUHASHI
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2007
Last Update Date: 06/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

999 E COLORADO BL
PASADENA CA
91106-2325
US

IV. Provider business mailing address

999 E COLORADO BLVD
PASADENA CA
91106-2325
US

V. Phone/Fax

Practice location:
  • Phone: 626-793-2476
  • Fax: 626-793-8095
Mailing address:
  • Phone: 626-793-2476
  • Fax: 626-793-8095

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code332B00000X
TaxonomyDurable Medical Equipment & Medical Supplies
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code335E00000X
TaxonomyProsthetic/Orthotic Supplier
License Number
License Number StateCA

VIII. Authorized Official

Name: YASUKO FURUHASHI
Title or Position: OWNER
Credential:
Phone: 626-793-2476