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General NPI Number Information
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NPI Number | 1205192010
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Entity Type | Organization
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Legal Business Name | MITCHELL K TAGUCHI MD INC
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Dates
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Enumeration Date | 04/05/2012
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Last Update Date | 04/05/2012
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Provider Practice Location Address
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Address Line | 3440 LOMITA BLVD SUITE 320
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City | TORRANCE
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State | CA
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Zip | 90505-4801
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Country | US
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Telephone | 310-534-8200
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 3098
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City | TORRANCE
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State | CA
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Zip | 90510-3098
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Country | US
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Telephone | 310-792-3914
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Fax | 855-898-4055
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Authorized Official
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Title or Position | PRESIDENT/ OWNER
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Name | MR. MITCHELL KOICHI TAGUCHI
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Credential | MD
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Telephone | 310-792-3914
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | A65921
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License Number State | CA
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