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Organization

SHO IZUMI, DDS, INC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SHO IZUMI DDS (PRESIDENT)
(818) 259-6740
Entity
Organization

Contact information

Practice address
23545 CRENSHAW BLVD, SUITE 105, TORRANCE, CA 90505-5218
(310) 323-2320
Mailing address
1568 W ARTESIA SQ UNIT F, GARDENA, CA 90248-4735

Taxonomy

Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
64992
CA

Other

Enumeration date
08/24/2015
Last updated
08/24/2015
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