Provider Demographics
NPI:1487849501
Name:TOCHIOKA, MIKIO M (DDS)
Entity Type:Individual
Prefix:DR
First Name:MIKIO
Middle Name:M
Last Name:TOCHIOKA
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90033-3505
Mailing Address - Country:US
Mailing Address - Phone:323-268-9386
Mailing Address - Fax:323-268-9524
Practice Address - Street 1:2621 E 1ST ST
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90033-3505
Practice Address - Country:US
Practice Address - Phone:323-268-9386
Practice Address - Fax:323-268-9524
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2007-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA193901223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice