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General NPI Number Information
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NPI Number | 1851709240
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Entity Type | Organization
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Legal Business Name | JAY IINUMA, MD, INC
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Dates
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Enumeration Date | 07/29/2014
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Last Update Date | 07/29/2014
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Provider Practice Location Address
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Address Line | 301 W HUNTINGTON DR STE 608
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City | ARCADIA
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State | CA
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Zip | 91007-1516
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Country | US
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Telephone | 626-201-5480
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Fax |
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Provider Business Mailing Address
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Address Line | 301 W HUNTINGTON DR STE 608
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City | ARCADIA
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State | CA
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Zip | 91007-1516
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Country | US
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Telephone | 626-201-5480
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Fax |
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Authorized Official
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Title or Position | PHYSICIAN
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Name | JAY IINUMA
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Credential | MD
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Telephone | 626-201-5480
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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