MEDICARE: DR. CHRISTOPHER MATTHEW HIROMURA M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A97223	CA

General Provider Information

NPI Number	:	1124213475
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER MATTHEW HIROMURA M.D.

Provider Business Mailing Address
First Line	:	5823 YORK BLVD STE 3
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90042-2634
Country	:	US
Telephone Number	:	323-255-5643
Fax Number	:	323-254-2158

Provider Business Practice Location Address
First Line	:	1701 E CESAR E CHAVEZ AVE STE 402
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90033-2496
Country	:	US
Telephone Number	:	323-226-1100
Fax Number	:	323-226-1101

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/10/2007
Last Update Date	:	01/11/2018

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