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Individual

MR. RAY S. KUSUMOTO

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PA

Contact information

Practice address
591 MCCRAY ST STE 231, HOLLISTER, CA 95023-2224
(831) 636-3116
(831) 636-1204
Mailing address
591 MCCRAY ST STE 231, HOLLISTER, CA 95023-2224
(831) 636-3116
(831) 636-1204

Taxonomy

Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
PA13954
CA

Other

Enumeration date
02/22/2007
Last updated
03/04/2025
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