Individual
DR. TAKEO KASUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
201 N WASHINGTON ST, KAISER PERMANENTE FALLS CHURCH MEDICAL CENTER, FALLS CHURCH, VA 22046-4518
(703) 237-4000
Mailing address
2101 E JEFFERSON ST, KAISER PERMANENTE MEDICARE ENROLLMENT, ROCKVILLE, MD 20852-4908
(301) 816-2424
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
25MA08067900
NJ
207L00000X
Anesthesiology Physician
0101246858
VA
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
0101246858
VA
207LP2900X
Pain Medicine (Anesthesiology) Physician
244484
NY
207LP2900X
Pain Medicine (Anesthesiology) Physician
A98695
CA
207LP2900X
Pain Medicine (Anesthesiology) Physician
D70091
MD
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD038530
DC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
017440
STATE LICENSE
ME
01
—
244484
NY STATE MEDICAL LICENSE
NY
01
—
25MA08067900
LICENSE
NJ
01
—
A98695
STATE LICENSE
CA
Enumeration date
08/10/2006
Last updated
06/01/2021
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