# ALAN T KAWAGUCHI

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1245285394
- **Gender:** Man
- **Credential:** MD

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207X00000X | Orthopaedic Surgery Physician | A55621 | CA | Yes |
| 207XS0114X | Adult Reconstructive Orthopaedic Surgery Physician | A55621 | CA | — |
| 207XX0004X | Orthopaedic Foot and Ankle Surgery Physician | A55621 | CA | — |
| 207XX0005X | Sports Medicine (Orthopaedic Surgery) Physician | A55621 | CA | — |
| 207XX0801X | Orthopaedic Trauma Physician | A55621 | CA | — |

## Other

- **Enumeration date:** 05/24/2006
- **Last updated:** 07/23/2025

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 0368640001 | DMERC | — |
| 01 | — | 195690700 | USDL | — |
| 01 | — | 200038615 | RR MEDICARE | — |
| 01 | — | CGP159090 | CGP\# | — |
| 05 | — | ZZZ71793Z | — | CA |