Healthcare Provider Details

I. General information

NPI: 1063700466
Provider Name (Legal Business Name): CARLOS GIANPAULO GASHA TAMASHIRO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2011
Last Update Date: 06/11/2025
Certification Date: 06/11/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8908 RIGGS RD
ADELPHI MD
20783-1632
US

IV. Provider business mailing address

4435 MADISON AVE APT 315N
KANSAS CITY MO
64111-5433
US

V. Phone/Fax

Practice location:
  • Phone: 301-422-5900
  • Fax:
Mailing address:
  • Phone: 973-865-2052
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberD0103766
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: