Individual
HITOMI EZUMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OD
Contact information
Practice address
1313 SOLANO AVE, ALBANY, CA 94706-1825
(510) 526-0194
Mailing address
1313 SOLANO AVE, ALBANY, CA 94706-1825
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
15139TLG
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12564555
CAQH PROVIDER NUMBER
PA
Enumeration date
07/18/2013
Last updated
06/27/2024
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