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General NPI Number Information
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NPI Number | 1801956842
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Entity Type | Organization
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Legal Business Name | HENRY K.KAWAMOTO, JR.,M.D,D.D.S.
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Dates
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Enumeration Date | 12/11/2006
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Last Update Date | 04/25/2008
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Provider Practice Location Address
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Address Line | 1301 20TH ST #460
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City | SANTA MONICA
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State | CA
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Zip | 90404-2050
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Country | US
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Telephone | 310-829-0391
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Fax | 310-828-3733
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Provider Business Mailing Address
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Address Line | 1301 20TH ST #460
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City | SANTA MONICA
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State | CA
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Zip | 90404-2050
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Country | US
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Telephone | 310-829-0391
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Fax | 310-828-3733
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. HENRY K KAWAMOTO JR.
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Credential | M.D.,D.D.S.
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Telephone | 310-829-0391
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | A21863
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License Number State | CA
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