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NPI Code Detail

MEDICARE: OMOTOLA TSARUMI MD

MEDICARE: OMOTOLA TSARUMI MD
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
1390200000XStudent in an Organized Health Care Education/Training Program
22084P0800XPsychiatry Physician277604MA

General Provider Information

NPI Number : 1710369376
Entity Type Code : Individual
Provider Name (Legal Business Name) : OMOTOLA TSARUMI MD
Provider Business Mailing Address
First Line : 332 WASHINGTON ST STE 360
Second Line :
City : WELLESLEY
State : MA
Zip : 02481-6204
Country : US
Telephone Number : 617-668-1239
Fax Number :
Provider Business Practice Location Address
First Line : 14541 DELANO ST
Second Line :
City : VAN NUYS
State : CA
Zip : 91411-2820
Country : US
Telephone Number : 617-467-0312
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2015
Last Update Date : 12/09/2025

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Directions to “ OMOTOLA TSARUMI MD” Practice Location

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