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Organization
BRIAN H. ITAGAKI M.D., INC.
Active
Organization
BRIAN H. ITAGAKI M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRIAN HIRO ITAGAKI M.D. (PRESIDENT)
(213) 484-7303
Entity
Organization
Contact information
Practice address
2200 W 3RD ST, SUITE 120A, LOS ANGELES, CA 90057-1932
(213) 484-7303
(213) 484-7399
Mailing address
2200 W 3RD ST, 120A, LOS ANGELES, CA 90057-1932
(213) 484-7303
(213) 484-7399
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G37936
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0004227410
AETNA
CA
01
—
006379360
BLUE SHIELD
CA
05
—
00G379360
—
CA
01
—
155649300
DEPARTMENT OF LABOR
CA
01
—
G37936
MEDICARE INDIVIDUAL PTAN
CA
Enumeration date
01/29/2007
Last updated
04/12/2013
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