Healthcare Provider Details

I. General information

NPI: 1851358915
Provider Name (Legal Business Name): ROBERT H OZAKI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2006
Last Update Date: 01/11/2022
Certification Date: 01/11/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

320 LENNON LN
WALNUT CREEK CA
94598-2419
US

IV. Provider business mailing address

1800 HARRISON ST 7TH FLOOR
OAKLAND CA
94612-3429
US

V. Phone/Fax

Practice location:
  • Phone: 925-532-4392
  • Fax:
Mailing address:
  • Phone: 510-625-5356
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number20A8665
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: