Healthcare Provider Details

I. General information

NPI: 1053878165
Provider Name (Legal Business Name): EORI TOKUNAGA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3671 BUSINESS DR
SACRAMENTO CA
95820-2197
US

IV. Provider business mailing address

3671 BUSINESS DR
SACRAMENTO CA
95820-2197
US

V. Phone/Fax

Practice location:
  • Phone: 916-732-8971
  • Fax:
Mailing address:
  • Phone: 916-732-8971
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code172V00000X
TaxonomyCommunity Health Worker
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: