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General NPI Number Information
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NPI Number | 1033744305
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Entity Type | Individual
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Provider Name | TIMOTHY KATSUHIRO SUGIMOTO DO
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Gender | Male
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Dates
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Enumeration Date | 03/07/2020
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Last Update Date | 11/19/2024
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Provider Practice Location Address
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Address Line | 2845 SIENA HEIGHTS DR
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City | HENDERSON
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State | NV
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Zip | 89052-4153
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Country | US
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Telephone | 702-877-5199
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Fax | 702-492-9574
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Provider Business Mailing Address
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Address Line | PO BOX 35380
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City | LAS VEGAS
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State | NV
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Zip | 89133-5380
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Country | US
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Telephone | 702-820-3635
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Fax | 702-804-3626
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | DO3658
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | DO3658
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License Number State | NV
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