Provider Demographics
NPI:1962432674
Name:HIGASHI, JULIE MIYO (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:JULIE
Middle Name:MIYO
Last Name:HIGASHI
Suffix:
Gender:F
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:976 LENZEN AVE
Mailing Address - Street 2:STE. 1700
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95126-2737
Mailing Address - Country:US
Mailing Address - Phone:408-792-1317
Mailing Address - Fax:408-885-2331
Practice Address - Street 1:976 LENZEN AVE
Practice Address - Street 2:STE. 1700
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95126-2737
Practice Address - Country:US
Practice Address - Phone:408-792-1317
Practice Address - Fax:408-885-2331
Is Sole Proprietor?:No
Enumeration Date:2006-07-05
Last Update Date:2010-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA73358207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA38480Medicare UPIN