Organization
KENNETH T SUMIDA MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH T SUMIDA MD (PRESIDENT)
(916) 984-4242
Entity
Organization
Contact information
Practice address
1641 CREEKSIDE DR STE 100, FOLSOM, CA 95630-3831
(916) 984-4242
(949) 588-2199
Mailing address
5 HOLLAND STE 101, IRVINE, CA 92618-2568
(949) 588-2190
(949) 588-2199
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
A67658
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
OOG574130
—
CA
Enumeration date
06/29/2009
Last updated
06/29/2009
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