Provider Demographics
NPI:1164708814
Name:FUJIKAMI, KEVIN T (CO, BOCP)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:T
Last Name:FUJIKAMI
Suffix:
Gender:M
Credentials:CO, BOCP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12200 WASHINGTON BLVD
Mailing Address - Street 2:SUITE M
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90606-2583
Mailing Address - Country:US
Mailing Address - Phone:562-945-4920
Mailing Address - Fax:562-945-9360
Practice Address - Street 1:12200 WASHINGTON BLVD
Practice Address - Street 2:SUITE M
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90606-2583
Practice Address - Country:US
Practice Address - Phone:562-945-4920
Practice Address - Fax:562-945-9360
Is Sole Proprietor?:No
Enumeration Date:2011-10-26
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes222Z00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersOrthotist
No224P00000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersProsthetist