Provider Demographics
NPI:1275720948
Name:FURUYA, YOSHIO JIMMY (MA)
Entity Type:Individual
Prefix:
First Name:YOSHIO
Middle Name:JIMMY
Last Name:FURUYA
Suffix:
Gender:M
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:960 E GREEN ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2401
Mailing Address - Country:US
Mailing Address - Phone:626-795-0679
Mailing Address - Fax:626-795-5822
Practice Address - Street 1:960 E GREEN ST
Practice Address - Street 2:SUITE 101
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2401
Practice Address - Country:US
Practice Address - Phone:626-795-0679
Practice Address - Fax:626-795-5822
Is Sole Proprietor?:Yes
Enumeration Date:2007-09-26
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAUD269231H00000X
CAHA1097237600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
No237600000XSpeech, Language and Hearing Service ProvidersAudiologist-Hearing Aid Fitter
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAZZZ71175ZMedicaid
CAHA1097OtherHEARING AID DISPENSER LIC
CAAUD269Medicare PIN