Provider Demographics
NPI:1417769654
Name:YAGASAKI, HIROTO
Entity type:Individual
Prefix:
First Name:HIROTO
Middle Name:
Last Name:YAGASAKI
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12820 APT2D
Mailing Address - Street 2:UNIVERSITY CRESCENT
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032
Mailing Address - Country:US
Mailing Address - Phone:317-516-8484
Mailing Address - Fax:
Practice Address - Street 1:12820 APT2D
Practice Address - Street 2:UNIVERSITY CRESCENT
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032
Practice Address - Country:US
Practice Address - Phone:317-516-8484
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-24
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1744R1102XOther Service ProvidersSpecialistResearch Study