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NPI Code Detail

MEDICARE: DR. ROBBIN KIKUO OKAMOTO DDS

MEDICARE: DR. ROBBIN KIKUO OKAMOTO DDS
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
1122300000XDentist20710CA

General Provider Information

NPI Number : 1871578013
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ROBBIN KIKUO OKAMOTO DDS
Provider Business Mailing Address
First Line : 50 BELLEFONTAINE ST
Second Line :
City : PASADENA
State : CA
Zip : 91105-3132
Country : US
Telephone Number : 626-440-9095
Fax Number : 626-440-9231
Provider Business Practice Location Address
First Line : 50 BELLEFONTAINE ST
Second Line :
City : PASADENA
State : CA
Zip : 91105-3132
Country : US
Telephone Number : 626-440-9095
Fax Number : 626-440-9231
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/09/2005
Last Update Date : 07/08/2007

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