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NPI Code Detail

MEDICARE: DR. KAZUO TOMIMATSU D.D.S.

MEDICARE:  DR. KAZUO  TOMIMATSU  D.D.S.
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
1122300000XDentist031718CA

General Provider Information

NPI Number : 1750538955
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KAZUO TOMIMATSU D.D.S.
Provider Business Mailing Address
First Line : 8930 S SEPULVEDA BLVD STE 211
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3624
Country : US
Telephone Number : 310-641-4074
Fax Number :
Provider Business Practice Location Address
First Line : 8930 S SEPULVEDA BLVD STE 211
Second Line :
City : LOS ANGELES
State : CA
Zip : 90045-3624
Country : US
Telephone Number : 310-641-4074
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/19/2008
Last Update Date : 08/19/2008

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Directions to “ DR. KAZUO TOMIMATSU D.D.S.” Practice Location

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