Provider Demographics
NPI:1770619140
Name:YASUDA, ATSUSHI (MD)
Entity type:Individual
Prefix:
First Name:ATSUSHI
Middle Name:
Last Name:YASUDA
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 1:2 NO 11 NO 1 KAGA
Mailing Address - Street 2:
Mailing Address - City:ITABASH KU
Mailing Address - State:TOKYO
Mailing Address - Zip Code:1730003
Mailing Address - Country:JP
Mailing Address - Phone:8133-964-1211
Mailing Address - Fax:
Practice Address - Street 1:2 NO 11 NO 1 KAGA
Practice Address - Street 2:
Practice Address - City:ITABASH KU
Practice Address - State:TOKYO
Practice Address - Zip Code:1730003
Practice Address - Country:JP
Practice Address - Phone:8133-964-1211
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2015-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA103181207L00000X
MA253319207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology