Healthcare Provider Details

I. General information

NPI: 1184758997
Provider Name (Legal Business Name): YOSHIKI RICHARD TOKUYAMA DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

911 HAMPSHIRE RD SUITE 4
WESTLAKE VILLAGE CA
91361-2818
US

IV. Provider business mailing address

911 HAMPSHIRE RD SUITE 4
WESTLAKE VILLAGE CA
91361-2818
US

V. Phone/Fax

Practice location:
  • Phone: 805-495-7416
  • Fax: 805-495-0086
Mailing address:
  • Phone: 805-495-7416
  • Fax: 805-495-0086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License Number19392
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: