Healthcare Provider Details

I. General information

NPI: 1730468471
Provider Name (Legal Business Name): NORIHIKO KAWAMATA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/12/2011
Last Update Date: 08/12/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8700 BEVERLY BLVD PACT4
WEST HOLLYWOOD CA
90048-1804
US

IV. Provider business mailing address

8700 BEVERLY BLVD PACT4
WEST HOLLYWOOD CA
90048-1804
US

V. Phone/Fax

Practice location:
  • Phone: 310-248-6211
  • Fax: 310-423-9752
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207SG0201X
TaxonomyClinical Genetics (M.D.) Physician
License NumberA117996
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: