Provider Demographics
NPI:1356313456
Name:FUJIKAWA, KEVIN DEL (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:DEL
Last Name:FUJIKAWA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:4944 SUNRISE BLVD STE H
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:95628-4941
Mailing Address - Country:US
Mailing Address - Phone:916-966-8158
Mailing Address - Fax:916-966-8118
Practice Address - Street 1:4944 SUNRISE BLVD STE H
Practice Address - Street 2:
Practice Address - City:FAIR OAKS
Practice Address - State:CA
Practice Address - Zip Code:95628-4941
Practice Address - Country:US
Practice Address - Phone:916-966-8158
Practice Address - Fax:916-966-8118
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-02
Last Update Date:2007-11-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG058555207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA53420Medicare UPIN