Individual
YUKI TAKASUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1328 22ND ST, DEPARTMENT OF PATHOLOGY, SANTA MONICA, CA 90404-2032
(310) 829-8101
(310) 829-6509
Mailing address
3230 PURDUE AVE, LOS ANGELES, CA 90066-1320
(310) 398-5674
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
A62456
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A624560
—
CA
Enumeration date
05/03/2006
Last updated
10/05/2007
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