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General NPI Number Information
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NPI Number | 1629426630
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Entity Type | Individual
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Provider Name | KEN MASUI FUJIMURA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/31/2016
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Last Update Date | 06/29/2025
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Provider Practice Location Address
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Address Line | 1015 N 1ST AVE APT A
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City | ARCADIA
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State | CA
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Zip | 91006-7401
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Country | US
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Telephone | 626-598-3770
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Fax | 626-598-3797
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Provider Business Mailing Address
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Address Line | 1015 N 1ST AVE APT A
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City | ARCADIA
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State | CA
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Zip | 91006-7401
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Country | US
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Telephone | 626-598-3770
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Fax | 626-598-3797
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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 | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | A154050
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | 2025-00310
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License Number State | NC
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Taxonomy #3
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Taxonomy Code | 2084N0400X
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Taxonomy Name | Neurology Physician
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License Number | DR.0068239
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License Number State | CO
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