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General NPI Number Information
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NPI Number | 1093433716
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Entity Type | Individual
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Provider Name | HIROE MATSUO
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Gender | Female
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Dates
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Enumeration Date | 08/18/2022
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Last Update Date | 08/23/2022
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Provider Practice Location Address
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Address Line | 2130 SAWTELLE BLVD 307
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City | LOS ANGELES
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State | CA
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Zip | 90025
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Country | US
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Telephone | 310-383-2905
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Fax |
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Provider Business Mailing Address
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Address Line | 269 S BEVERLY DR # 739
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City | BEVERLY HILLS
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State | CA
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Zip | 90212-3851
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Country | US
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Telephone | 310-383-2905
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Fax |
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | 80100
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License Number State | CA
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