Provider Demographics
NPI:1558534552
Name:KIKUCHI, NORMAN DENNIS (MD)
Entity Type:Individual
Prefix:DR
First Name:NORMAN
Middle Name:DENNIS
Last Name:KIKUCHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:245 MOUNT HERMON RD STE M
Mailing Address - Street 2:
Mailing Address - City:SCOTTS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95066-4045
Mailing Address - Country:US
Mailing Address - Phone:831-459-9424
Mailing Address - Fax:
Practice Address - Street 1:4156 MANZANITA AVE # 100
Practice Address - Street 2:
Practice Address - City:CARMICHAEL
Practice Address - State:CA
Practice Address - Zip Code:95608-1726
Practice Address - Country:US
Practice Address - Phone:916-483-5400
Practice Address - Fax:916-483-1937
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2008-04-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAG39532207QA0505X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QA0505XAllopathic & Osteopathic PhysiciansFamily MedicineAdult Medicine