Provider Demographics
NPI:1780729327
Name:TSUCHIYA, OWEN KIYOSHI (MD)
Entity type:Individual
Prefix:
First Name:OWEN
Middle Name:KIYOSHI
Last Name:TSUCHIYA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:600 PACIFIC COAST HIGHWAY
Mailing Address - Street 2:SUITE 210
Mailing Address - City:SEAL BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90740-6600
Mailing Address - Country:US
Mailing Address - Phone:562-594-9607
Mailing Address - Fax:562-795-1659
Practice Address - Street 1:600 PACIFIC COAST HIGHWAY
Practice Address - Street 2:SUITE 210
Practice Address - City:SEAL BEACH
Practice Address - State:CA
Practice Address - Zip Code:90740-6600
Practice Address - Country:US
Practice Address - Phone:562-594-9607
Practice Address - Fax:562-795-1659
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-21
Last Update Date:2010-12-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG272352084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
A91038Medicare UPIN