Provider Demographics
NPI:1356536015
Name:AKAZAWA, MELVIN KAORU (MD)
Entity type:Individual
Prefix:MR
First Name:MELVIN
Middle Name:KAORU
Last Name:AKAZAWA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:26732 CROWN VALLEY PARKWAY
Mailing Address - Street 2:SUITE 381
Mailing Address - City:MISSION VIEJO
Mailing Address - State:CA
Mailing Address - Zip Code:92691
Mailing Address - Country:US
Mailing Address - Phone:949-364-2150
Mailing Address - Fax:949-364-1003
Practice Address - Street 1:26732 CROWN VALLEY PARKWAY
Practice Address - Street 2:SUITE 381
Practice Address - City:MISSION VIEJO
Practice Address - State:CA
Practice Address - Zip Code:92691
Practice Address - Country:US
Practice Address - Phone:949-364-2150
Practice Address - Fax:949-364-1003
Is Sole Proprietor?:No
Enumeration Date:2007-09-06
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA267402086S0122X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0122XAllopathic & Osteopathic PhysiciansSurgeryPlastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
A83430Medicare UPIN