Provider Demographics
NPI:1497764641
Name:HAYASHIDA, KENNETH HIROSHI JR (MD)
Entity Type:Individual
Prefix:DR
First Name:KENNETH
Middle Name:HIROSHI
Last Name:HAYASHIDA
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:25982 PALA
Mailing Address - Street 2:SUITE 100
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691-6719
Mailing Address - Country:US
Mailing Address - Phone:949-916-5437
Mailing Address - Fax:949-215-3623
Practice Address - Street 1:25982 PALA
Practice Address - Street 2:SUITE 100
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691-6719
Practice Address - Country:US
Practice Address - Phone:949-916-5437
Practice Address - Fax:949-215-3623
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA056162208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics