Healthcare Provider Details

I. General information

NPI: 1760777528
Provider Name (Legal Business Name): YOUSUKE TAKASHI HORIKAWA M.D.,PH.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HOWARD YOUSUKE HAMAI

II. Dates (important events)

Enumeration Date: 06/09/2011
Last Update Date: 10/08/2020
Certification Date: 10/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8701 CUYAMACA ST
SANTEE CA
92071
US

IV. Provider business mailing address

8701 CUYAMACA ST
SANTEE CA
92071
US

V. Phone/Fax

Practice location:
  • Phone: 858-499-2701
  • Fax: 619-568-8098
Mailing address:
  • Phone: 858-499-2701
  • Fax: 619-568-8098

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberA123209
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: