Healthcare Provider Details

I. General information

NPI: 1306938055
Provider Name (Legal Business Name): MASAMI HATTORI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/29/2006
Last Update Date: 11/27/2025
Certification Date: 11/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1 SHRADER ST STE 600
SAN FRANCISCO CA
94117-1018
US

IV. Provider business mailing address

1 SHRADER ST STE 600
SAN FRANCISCO CA
94117-1018
US

V. Phone/Fax

Practice location:
  • Phone: 415-292-9756
  • Fax: 415-292-3481
Mailing address:
  • Phone: 415-292-9756
  • Fax: 415-292-3481

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208VP0000X
TaxonomyPain Medicine Physician
License NumberA61067
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: