MEDICARE: DANIEL H TAMURA, DDS, A PROFESSIONAL CORPORATION

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	1223G0001X	General Practice Dentistry	29676	CA

General Provider Information

NPI Number	:	1497764690
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	DANIEL H TAMURA, DDS, A PROFESSIONAL CORPORATION

Provider Business Mailing Address
First Line	:	6200 WILSHIRE BLVD STE 1209
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5813
Country	:	US
Telephone Number	:	323-937-0197
Fax Number	:	323-937-1257

Provider Business Practice Location Address
First Line	:	6200 WILSHIRE BLVD STE 1209
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90048-5813
Country	:	US
Telephone Number	:	323-937-0197
Fax Number	:	323-937-1257

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. DANIEL HIDEO TAMURA
Credential	:	DDS
Telephone Number	:	323-937-0197

Provider Enumeration Date	:	08/05/2006
Last Update Date	:	08/22/2020

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