Provider Demographics
NPI:1962522540
Name:KUNIHIRA, DALE YUKITO (MD)
Entity type:Individual
Prefix:
First Name:DALE
Middle Name:YUKITO
Last Name:KUNIHIRA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:710 LAWRENCE EXPY
Mailing Address - Street 2:DEPT 448
Mailing Address - City:SANTA CLARA
Mailing Address - State:CA
Mailing Address - Zip Code:95051-5173
Mailing Address - Country:US
Mailing Address - Phone:408-851-4515
Mailing Address - Fax:408-851-4509
Practice Address - Street 1:710 LAWRENCE EXPY
Practice Address - Street 2:DEPT 448
Practice Address - City:SANTA CLARA
Practice Address - State:CA
Practice Address - Zip Code:95051-5173
Practice Address - Country:US
Practice Address - Phone:408-851-4515
Practice Address - Fax:408-851-4509
Is Sole Proprietor?:No
Enumeration Date:2007-03-29
Last Update Date:2021-12-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG059137208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G591370Medicaid
CA00G591370Medicaid