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General NPI Number Information
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NPI Number | 1134465651
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Entity Type | Organization
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Legal Business Name | R.T. HAYASHI, DDS, INC.
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Dates
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Enumeration Date | 01/03/2013
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Last Update Date | 02/03/2016
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Provider Practice Location Address
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Address Line | 5723 MARCONI AVE SUITE A
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City | CARMICHAEL
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State | CA
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Zip | 95608-4475
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Country | US
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Telephone | 916-489-9990
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Fax | 916-489-9998
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Provider Business Mailing Address
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Address Line | 5723 MARCONI AVE SUITE A
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City | CARMICHAEL
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State | CA
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Zip | 95608-4475
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Country | US
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Telephone | 916-489-9990
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Fax | 916-489-9998
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Authorized Official
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Title or Position | CEO
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Name | DR. RANDALL T HAYASHI
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Credential | DDS
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Telephone | 916-489-9990
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 302R00000X
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Taxonomy Name | Health Maintenance Organization
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License Number | 36765
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License Number State | CA
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