Provider Demographics
NPI:1720445042
Name:INOUE, AIKO
Entity Type:Individual
Prefix:
First Name:AIKO
Middle Name:
Last Name:INOUE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 MCALLISTER ST APT 205
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94118-4443
Mailing Address - Country:US
Mailing Address - Phone:336-407-1639
Mailing Address - Fax:
Practice Address - Street 1:2001 MCALLISTER ST APT 205
Practice Address - Street 2:
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94118-4443
Practice Address - Country:US
Practice Address - Phone:336-407-1639
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-01-16
Last Update Date:2016-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA59679183500000X
NC16652183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist