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1740398023 NPI number — BRIAN HIRO ITAGAKI MD

NPI Number: 1740398023
Health Care Provider/Practitioner: BRIAN HIRO ITAGAKI MD

Information about “1740398023” NPI (BRIAN HIRO ITAGAKI MD) exists in 1740398023 in HTML format HTML  |  1740398023 in plain Text format TXT  |  1740398023 in PDF (Portable Document Format) PDF  |  1740398023 in an XML format XML  formats.

NPI Number : 1740398023 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1740398023",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "ITAGAKI",
    "FirstName": "BRIAN",
    "MiddleName": "HIRO",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": "ITAGAKI M.D. INC.",
    "OtherFirstName": "BRIAN",
    "OtherMiddleName": "H",
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": "M.D.",
    "OtherLastNameTypeCode": "5",
    "FirstLineMailingAddress": "2200 W 3RD ST",
    "SecondLineMailingAddress": "SUITE 400",
    "MailingAddressCityName": "LOS ANGELES",
    "MailingAddressStateName": "CA",
    "MailingAddressPostalCode": "90057-1932",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "213-484-7600",
    "MailingAddressFaxNumber": "213-484-7566",
    "FirstLinePracticeLocationAddress": "2200 W 3RD ST",
    "SecondLinePracticeLocationAddress": "SUITE 400",
    "PracticeLocationAddressCityName": "LOS ANGELES",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "90057-1932",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "213-484-7600",
    "PracticeLocationAddressFaxNumber": "213-484-7566",
    "EnumerationDate": "08/28/2006",
    "LastUpdateDate": "11/11/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "207X00000X",
        "TaxonomyName": "Orthopaedic Surgery Physician",
        "LicenseNumber": "G37936",
        "LicenseNumberStateCode": "CA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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