Provider Demographics
NPI:1558491480
Name:YASUKO FURUHASHI
Entity Type:Organization
Organization Name:YASUKO FURUHASHI
Other - Org Name:YASUKO BRA AND LINGERIE SALON
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:YASUKO
Authorized Official - Middle Name:
Authorized Official - Last Name:FURUHASHI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:626-793-2476
Mailing Address - Street 1:999 E COLORADO BLVD
Mailing Address - Street 2:
Mailing Address - City:PASADENA
Mailing Address - State:CA
Mailing Address - Zip Code:91106-2325
Mailing Address - Country:US
Mailing Address - Phone:626-793-2476
Mailing Address - Fax:626-793-8095
Practice Address - Street 1:999 E COLORADO BL
Practice Address - Street 2:
Practice Address - City:PASADENA
Practice Address - State:CA
Practice Address - Zip Code:91106-2325
Practice Address - Country:US
Practice Address - Phone:626-793-2476
Practice Address - Fax:626-793-8095
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-07
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
332B00000X
CA335E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
No335E00000XSuppliersProsthetic/Orthotic Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA6050680001Medicare NSC
CA6050680001Medicare PIN