Provider Demographics
NPI:1952471922
Name:AUGUSTUS, KAZUTO H (DPM)
Entity Type:Individual
Prefix:DR
First Name:KAZUTO
Middle Name:H
Last Name:AUGUSTUS
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1760 TERMINO AVE
Mailing Address - Street 2:SUITE 309
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90804-2105
Mailing Address - Country:US
Mailing Address - Phone:562-986-6886
Mailing Address - Fax:562-986-6885
Practice Address - Street 1:1760 TERMINO AVE
Practice Address - Street 2:SUITE 309
Practice Address - City:LONG BEACH
Practice Address - State:CA
Practice Address - Zip Code:90804-2105
Practice Address - Country:US
Practice Address - Phone:562-986-6887
Practice Address - Fax:562-986-6885
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAE4465213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAU94616OtherUPN
CAU94616OtherUPN
CAE4465AMedicare UPIN