Provider Demographics
NPI:1073638086
Name:NAKATSUCHI, HIROFUMI (DDS)
Entity type:Individual
Prefix:DR
First Name:HIROFUMI
Middle Name:
Last Name:NAKATSUCHI
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:441 DIAZ AVE
Mailing Address - Street 2:
Mailing Address - City:DELANO
Mailing Address - State:CA
Mailing Address - Zip Code:93215-4121
Mailing Address - Country:US
Mailing Address - Phone:661-725-3882
Mailing Address - Fax:661-721-2486
Practice Address - Street 1:441 DIAZ AVE
Practice Address - Street 2:
Practice Address - City:DELANO
Practice Address - State:CA
Practice Address - Zip Code:93215-4121
Practice Address - Country:US
Practice Address - Phone:661-725-3882
Practice Address - Fax:661-721-2486
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2010-02-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA515321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA51532OtherCALIFORNIA DENTAL LIC#