Provider Demographics
NPI:1942230503
Name:KATO, EAMON (MD)
Entity Type:Individual
Prefix:
First Name:EAMON
Middle Name:
Last Name:KATO
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 1:5767 W CENTURY BLVD
Mailing Address - Street 2:
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90045-5631
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:10833 LE CONTE AVE
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3075
Practice Address - Country:US
Practice Address - Phone:310-825-4721
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-03
Last Update Date:2021-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA955862085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A955860Medicaid
CABG553XMedicare PIN
CAAX148TMedicare PIN
CAAX148UMedicare PIN
CAAX148ZMedicare PIN
CABG553VMedicare PIN
CAWA895586AMedicare PIN
CAAX148SMedicare PIN
CAI61817Medicare UPIN
CABG553ZMedicare PIN
CABG553WMedicare PIN
CA00A955860Medicaid
CABG553YMedicare PIN
CABO375ZMedicare PIN