Provider Demographics
NPI:1275522484
Name:KAKITA, LENORE SETSUKO (MD)
Entity Type:Individual
Prefix:DR
First Name:LENORE
Middle Name:SETSUKO
Last Name:KAKITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LENORE
Other - Middle Name:SETSUKO
Other - Last Name:UYEYAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:225 S EUCLID AVE
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91101-2717
Mailing Address - Country:US
Mailing Address - Phone:626-584-9933
Mailing Address - Fax:626-584-9333
Practice Address - Street 1:225 S EUCLID AVE
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91101-2717
Practice Address - Country:US
Practice Address - Phone:626-584-9933
Practice Address - Fax:626-584-9333
Is Sole Proprietor?:No
Enumeration Date:2005-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA23000207N00000X
NV11979207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAW110992Medicare ID - Type Unspecified
CAWA23000BMedicare ID - Type Unspecified
A23352Medicare UPIN