Provider Demographics
NPI:1942371430
Name:TOKUYAMA, EISAKU (LAC)
Entity Type:Individual
Prefix:MR
First Name:EISAKU
Middle Name:
Last Name:TOKUYAMA
Suffix:
Gender:M
Credentials:LAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2121 YGNACIO VALLEY RD
Mailing Address - Street 2:SUITE G1
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-3383
Mailing Address - Country:US
Mailing Address - Phone:925-946-1718
Mailing Address - Fax:
Practice Address - Street 1:2121 YGNACIO VALLEY RD
Practice Address - Street 2:SUITE G1
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-3383
Practice Address - Country:US
Practice Address - Phone:925-946-1718
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10936171100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171100000XOther Service ProvidersAcupuncturist