Provider Demographics
NPI:1326265315
Name:FURUMOTO, YASUKO MARGIE (MD)
Entity Type:Individual
Prefix:DR
First Name:YASUKO
Middle Name:MARGIE
Last Name:FURUMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MRS
Other - First Name:YASUKO
Other - Middle Name:MARGIE
Other - Last Name:SAKIMURA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:849 W 34TH ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90089-0311
Mailing Address - Country:US
Mailing Address - Phone:213-740-9355
Mailing Address - Fax:213-740-4322
Practice Address - Street 1:849 W 34TH ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90089-0311
Practice Address - Country:US
Practice Address - Phone:213-740-9355
Practice Address - Fax:213-740-4322
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG16173207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA90414Medicare UPIN
CAW 15456Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER