Provider Demographics
NPI:1770571382
Name:NOGUCHI, HENRY T (MD)
Entity type:Individual
Prefix:DR
First Name:HENRY
Middle Name:T
Last Name:NOGUCHI
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Gender:M
Credentials:MD
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Mailing Address - Street 1:4201 TORRANCE BLVD
Mailing Address - Street 2:SUITE 580
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90503-4528
Mailing Address - Country:US
Mailing Address - Phone:310-540-5494
Mailing Address - Fax:310-540-5847
Practice Address - Street 1:4201 TORRANCE BLVD
Practice Address - Street 2:SUITE 580
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90503-4528
Practice Address - Country:US
Practice Address - Phone:310-540-5494
Practice Address - Fax:310-540-5847
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-07
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
CAC29251207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00C292510Medicaid
CAA33868Medicare UPIN
CA00C292510Medicaid