Provider Demographics
NPI:1073777579
Name:ITO, HIROKI (MD)
Entity Type:Individual
Prefix:DR
First Name:HIROKI
Middle Name:
Last Name:ITO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:4000 PHYSICIAN'S BLVD
Mailing Address - Street 2:BLDG E #101
Mailing Address - City:BAKERSFIELD
Mailing Address - State:CA
Mailing Address - Zip Code:93301-1284
Mailing Address - Country:US
Mailing Address - Phone:661-327-0807
Mailing Address - Fax:661-327-7593
Practice Address - Street 1:4000 PHYSICIANS BLVD
Practice Address - Street 2:BLDG E #101
Practice Address - City:BAKERSFIELD
Practice Address - State:CA
Practice Address - Zip Code:93301-5839
Practice Address - Country:US
Practice Address - Phone:661-327-0807
Practice Address - Fax:661-327-7593
Is Sole Proprietor?:No
Enumeration Date:2008-07-14
Last Update Date:2010-08-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IL036116640207R00000X, 207RC0000X, 390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program