Provider Demographics
NPI:1932394533
Name:OKU, TATSUHIRO
Entity Type:Individual
Prefix:
First Name:TATSUHIRO
Middle Name:
Last Name:OKU
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 8TH ST
Mailing Address - Street 2:
Mailing Address - City:OAKLAND
Mailing Address - State:CA
Mailing Address - Zip Code:94607-6526
Mailing Address - Country:US
Mailing Address - Phone:510-869-6045
Mailing Address - Fax:
Practice Address - Street 1:310 8TH ST
Practice Address - Street 2:
Practice Address - City:OAKLAND
Practice Address - State:CA
Practice Address - Zip Code:94607-6526
Practice Address - Country:US
Practice Address - Phone:510-869-6045
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-09-07
Last Update Date:2007-09-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program