Healthcare Provider Details

I. General information

NPI: 1922704949
Provider Name (Legal Business Name): SEIGO KUWANO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/01/2023
Last Update Date: 06/20/2025
Certification Date: 06/20/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2115 THE ALAMEDA
SAN JOSE CA
95126-1141
US

IV. Provider business mailing address

1785 CAMPUS RD
LOS ANGELES CA
90041-3034
US

V. Phone/Fax

Practice location:
  • Phone: 925-939-8585
  • Fax: 925-933-2709
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2251X0800X
TaxonomyOrthopedic Physical Therapist
License Number308140
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: