Provider Demographics
NPI:1588626675
Name:HAYASHI, HOWARD H (MD)
Entity Type:Individual
Prefix:DR
First Name:HOWARD
Middle Name:H
Last Name:HAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:77 CASA ST
Mailing Address - Street 2:SUITE 103
Mailing Address - City:SAN LUIS OBISPO
Mailing Address - State:CA
Mailing Address - Zip Code:93405-5803
Mailing Address - Country:US
Mailing Address - Phone:805-546-0411
Mailing Address - Fax:805-489-1421
Practice Address - Street 1:77 CASA ST
Practice Address - Street 2:SUITE 103
Practice Address - City:SAN LUIS OBISPO
Practice Address - State:CA
Practice Address - Zip Code:93405-5803
Practice Address - Country:US
Practice Address - Phone:805-546-0411
Practice Address - Fax:805-489-1421
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2009-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG50871208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G508710Medicaid
CAZZZ23194ZOtherBLUE SHIELD
CA020015428Medicare PIN
CA00G508710Medicaid
CAWG50871DMedicare PIN