Provider Demographics
NPI:1669425575
Name:TSUNEISHI, CHRIS MAKOTO (MD)
Entity type:Individual
Prefix:DR
First Name:CHRIS
Middle Name:MAKOTO
Last Name:TSUNEISHI
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 1:2830 SUNNYGLEN RD
Mailing Address - Street 2:
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-7131
Mailing Address - Country:US
Mailing Address - Phone:310-517-9133
Mailing Address - Fax:
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 360
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4504
Practice Address - Country:US
Practice Address - Phone:310-543-1050
Practice Address - Fax:310-543-1049
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-19
Last Update Date:2018-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA68447207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAH22555Medicare UPIN
CAA68447Medicare ID - Type UnspecifiedMEDICARE NUMBER