Provider Demographics
NPI:1023028883
Name:MOCHIZUKI, ROBERT MICHELE (MD)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MICHELE
Last Name:MOCHIZUKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 27708
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93729-7708
Mailing Address - Country:US
Mailing Address - Phone:559-433-3374
Mailing Address - Fax:559-432-3378
Practice Address - Street 1:7255 N CEDAR AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-3831
Practice Address - Country:US
Practice Address - Phone:559-433-3374
Practice Address - Fax:559-432-3378
Is Sole Proprietor?:No
Enumeration Date:2006-08-08
Last Update Date:2014-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG32450207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00611591OtherRAILROAD MEDICARE
CAZZZ67459ZOtherBLUE SHIELD
CA00G324500Medicare PIN
CAZZZ67459ZOtherBLUE SHIELD