Provider Demographics
NPI:1922277672
Name:TAKAYAMA, NORIO (MD)
Entity Type:Individual
Prefix:
First Name:NORIO
Middle Name:
Last Name:TAKAYAMA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2625 E DIVISADERO ST
Mailing Address - Street 2:
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93721-1431
Mailing Address - Country:US
Mailing Address - Phone:559-443-2682
Mailing Address - Fax:559-443-2681
Practice Address - Street 1:255 N HERWALDT DR
Practice Address - Street 2:
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93701-2186
Practice Address - Country:US
Practice Address - Phone:559-459-7300
Practice Address - Fax:559-459-3750
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-27
Last Update Date:2014-06-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA20058208200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208200000XAllopathic & Osteopathic PhysiciansPlastic Surgery