Provider Demographics
NPI:1811089402
Name:FUJIMOTO, RONALD J (DO)
Entity type:Individual
Prefix:
First Name:RONALD
Middle Name:J
Last Name:FUJIMOTO
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:13980 BLOSSOM HILL RD
Mailing Address - Street 2:STE B
Mailing Address - City:LOS GATOS
Mailing Address - State:CA
Mailing Address - Zip Code:95032-5121
Mailing Address - Country:US
Mailing Address - Phone:408-445-8400
Mailing Address - Fax:408-445-0875
Practice Address - Street 1:13980 BLOSSOM HILL RD STE D
Practice Address - Street 2:
Practice Address - City:LOS GATOS
Practice Address - State:CA
Practice Address - Zip Code:95032-5121
Practice Address - Country:US
Practice Address - Phone:408-445-8400
Practice Address - Fax:408-445-0875
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2020-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA20A61742081P2900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2081P2900XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationPain Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAF 36148Medicare UPIN