Individual
RONALD TAKESHI MITSUYASU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 MEDICAL PLAZA, #365,420,120,530, LOS ANGELES, CA 90095
(310) 794-9718
(310) 557-1899
Mailing address
5767 W CENTURY BLVD, SUITE 200, LOS ANGELES, CA 90045-5632
(310) 557-1891
(310) 557-1899
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G44685
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G446850
—
CA
Enumeration date
07/19/2006
Last updated
02/18/2010
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