MEDICARE: MR. MARTIN AKIMOTO L.C.S.W.

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	1041C0700X	Clinical Social Worker	LCS 5946	CA

General Provider Information

NPI Number	:	1942312145
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. MARTIN AKIMOTO L.C.S.W.

Provider Business Mailing Address
First Line	:	2280 BLOOMINGTON AVE
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-9418
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2571 CALIFORNIA PARK DR STE 210
Second Line	:
City	:	CHICO
State	:	CA
Zip	:	95928-4042
Country	:	US
Telephone Number	:	530-899-1005
Fax Number	:

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

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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