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NPI Number : 1396977575
Entity Type Code : Individual
Provider Name (Legal Business Name) : YURIO MIYAZAWA
Provider Business Mailing Address
First Line : 3626 BALBOA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94121-2604
Country : US
Telephone Number : 415-668-5955
Fax Number :
Provider Business Practice Location Address
First Line : 3626 BALBOA ST
Second Line :
City : SAN FRANCISCO
State : CA
Zip : 94121-2604
Country : US
Telephone Number : 415-668-5955
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/20/2009
Last Update Date : 09/07/2011