=====================================================
General NPI Number Information
=====================================================
NPI Number | 1124147046
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | MOTOO ARAKI M.D.
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2007
-----------------------------------------------------
Last Update Date | 07/08/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1919 E 2ND ST APT 271
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73034-6227
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-877-4739
-----------------------------------------------------
Fax | 405-271-6900
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1919 E 2ND STREET #271
-----------------------------------------------------
City | EDMOND
-----------------------------------------------------
State | OK
-----------------------------------------------------
Zip | 73034
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 786-877-4739
-----------------------------------------------------
Fax | 405-271-6900
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 208800000X
-----------------------------------------------------
Taxonomy Name | Urology Physician
-----------------------------------------------------
License Number | 24740
-----------------------------------------------------
License Number State | OK
-----------------------------------------------------