Provider Demographics
NPI:1912938150
Name:NARIMATSU MEDICAL CORPORATION
Entity Type:Organization
Organization Name:NARIMATSU MEDICAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/CEO
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:KIYOSHI
Authorized Official - Last Name:NARIMATSU
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:310-922-7601
Mailing Address - Street 1:221 ROSECRANS AVE
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90266-3277
Mailing Address - Country:US
Mailing Address - Phone:310-922-7201
Mailing Address - Fax:310-670-6735
Practice Address - Street 1:1200 N VERMONT AVE STE D
Practice Address - Street 2:
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90029-1760
Practice Address - Country:US
Practice Address - Phone:323-953-1180
Practice Address - Fax:323-953-1179
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA88839261QM1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAI30299Medicare UPIN