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General NPI Number Information
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NPI Number | 1992096846
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Entity Type | Individual
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Provider Name | OSAMU FERNANDO KANEKO MD
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Gender | Male
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Dates
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Enumeration Date | 04/27/2011
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Last Update Date | 09/13/2019
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Provider Practice Location Address
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Address Line | 1425 S MAIN ST
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City | WALNUT CREEK
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State | CA
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Zip | 94596
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Country | US
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Telephone | 925-393-6970
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Fax |
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Provider Business Mailing Address
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Address Line | 398 NORTHWOOD DR
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City | GUILFORD
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State | CT
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Zip | 06437-1156
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Country | US
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Telephone | 415-613-4776
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Fax |
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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 | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | A118233
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License Number State | CA
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