Healthcare Provider Details

I. General information

NPI: 1518279710
Provider Name (Legal Business Name): ALAN TSUYOSHI KURAMOTO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/06/2010
Last Update Date: 12/17/2021
Certification Date: 11/09/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 W ARBOR DR # 8756
SAN DIEGO CA
92103-1911
US

IV. Provider business mailing address

1800 HARRISON ST FL 7
OAKLAND CA
94612-3466
US

V. Phone/Fax

Practice location:
  • Phone: 619-543-6607
  • Fax:
Mailing address:
  • Phone: 619-543-6607
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085B0100X
TaxonomyBody Imaging Physician
License NumberA120680
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA120680
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: