1962954792 NPI number — MITSUAKI DAVID KATO, O.D., INC.

Table of Contents

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1962954792 NPI number — MITSUAKI DAVID KATO, O.D., INC.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
MITSUAKI DAVID KATO, O.D., INC.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1962954792
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
10/27/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
12040 HAMMACK ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
CULVER CITY
Provider Business Mailing Address State Name:
CA
Provider Business Mailing Address Postal Code:
90230-5922
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
310-266-3155
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
6000 SEPULVEDA BLVD STE 1680
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
CULVER CITY
Provider Business Practice Location Address State Name:
CA
Provider Business Practice Location Address Postal Code:
90230-6429
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
310-390-2142
Provider Business Practice Location Address Fax Number:
310-397-5306
Provider Enumeration Date:
10/27/2016

Additional Information

Authorized Official

Authorized Official Last Name:
KATO
Authorized Official First Name:
MITSUAKI
Authorized Official Middle Name:
DAVID
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
310-266-3155

Provider Taxonomy Codes

  • Taxonomy code: 152W00000X , with the licence number:  10896T , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com