Provider Demographics
NPI:1346682804
Name:MAYEDA, BRIAN FUMIO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRIAN
Middle Name:FUMIO
Last Name:MAYEDA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:601 BROADWAY FL 6
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-5330
Mailing Address - Country:US
Mailing Address - Phone:206-386-2600
Mailing Address - Fax:206-622-1644
Practice Address - Street 1:5215 TORRANCE BLVD
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4009
Practice Address - Country:US
Practice Address - Phone:310-316-6190
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-25
Last Update Date:2023-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD60956312207X00000X, 207XS0114X
CAA133834207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207XS0114XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryAdult Reconstructive Orthopaedic Surgery