Provider Demographics
NPI:1154647501
Name:YAMAZAKI, KUNINAGA
Entity Type:Individual
Prefix:MR
First Name:KUNINAGA
Middle Name:
Last Name:YAMAZAKI
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 1:2009 PREUSS RD
Mailing Address - Street 2:#9
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90034-1242
Mailing Address - Country:US
Mailing Address - Phone:424-288-9473
Mailing Address - Fax:
Practice Address - Street 1:2009 PREUSS RD
Practice Address - Street 2:#9
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90034-1242
Practice Address - Country:US
Practice Address - Phone:424-288-9473
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-09
Last Update Date:2010-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program