14/05/07 12:58:32.41 6zhJqax40
NPI Number 1396977575 has the “Individual” type of ownership and has been registered to the following primary business legal name (which is a provider name or healthcare organization name) ― YURIO MIYAZAWA .
Records indicate that the provider gender is “Male”.
The enumeration date of this NPI Number is 08/20/2009.
NPI Numer information was last updated at 09/07/2011.
The provider is physically located (Business Practice Location) at:
3626 BALBOA ST
SAN FRANCISCO , CA
94121-2604
US
The provider can be reached at his practice location using the following numbers:
Phone 415-668-5955
Fax
The provider's official mailing address is:
3626 BALBOA ST
SAN FRANCISCO , CA
94121-2604
US
The contact numbers associated with the mailing address are:
Phone 415-668-5955
Fax
The authorized official registered with the “1396977575” NPI Number is .