Provider Demographics
NPI:1760468102
Name:SUMIDA, PAUL MORIHIKO (OD)
Entity Type:Individual
Prefix:DR
First Name:PAUL
Middle Name:MORIHIKO
Last Name:SUMIDA
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:STE 580
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503
Mailing Address - Country:US
Mailing Address - Phone:310-316-6726
Mailing Address - Fax:310-316-6716
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:STE 580
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503
Practice Address - Country:US
Practice Address - Phone:310-316-6726
Practice Address - Fax:310-316-6716
Is Sole Proprietor?:No
Enumeration Date:2005-12-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CA4674T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
T69932Medicare UPIN