Provider Demographics
NPI:1134231384
Name:HIRAI, THOMAS JUN (MD)
Entity type:Individual
Prefix:
First Name:THOMAS
Middle Name:JUN
Last Name:HIRAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3141 STEVENS CREEK BLVD
Mailing Address - Street 2:#351
Mailing Address - City:SAN JOSE
Mailing Address - State:CA
Mailing Address - Zip Code:95117-1141
Mailing Address - Country:US
Mailing Address - Phone:669-284-8181
Mailing Address - Fax:669-284-8182
Practice Address - Street 1:200 JOSE FIGUERES AVE
Practice Address - Street 2:#450
Practice Address - City:SAN JOSE
Practice Address - State:CA
Practice Address - Zip Code:95116-1500
Practice Address - Country:US
Practice Address - Phone:669-284-8181
Practice Address - Fax:669-284-8182
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2017-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA84170208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8463275Medicaid
WA0255618OtherSTATE L&I
WA8944451OtherCRIME VICTIMS
WAP00616473OtherRAILROAD
WA213007OtherL & I
WA8944451OtherCRIME VICTIMS
WAP00616473OtherRAILROAD
WAG8861922Medicare PIN