Provider Demographics
NPI:1962635680
Name:MASAMI HATTORI MD INC.
Entity Type:Organization
Organization Name:MASAMI HATTORI MD INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MASAMI
Authorized Official - Middle Name:
Authorized Official - Last Name:HATTORI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:415-331-8390
Mailing Address - Street 1:1700 CALIFORNIA ST
Mailing Address - Street 2:STE 340
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94109-4586
Mailing Address - Country:US
Mailing Address - Phone:415-331-8390
Mailing Address - Fax:415-331-8380
Practice Address - Street 1:2250 HAYES ST STE 501
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94117-1078
Practice Address - Country:US
Practice Address - Phone:415-292-9756
Practice Address - Fax:415-292-3481
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-08-27
Last Update Date:2023-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA61067207L00000X
261QP3300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP3300XAmbulatory Health Care FacilitiesClinic/CenterPain
No207L00000XAllopathic & Osteopathic PhysiciansAnesthesiologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A610671Medicare PIN
CAH32098Medicare UPIN