Individual
JUSTIN M SUGAMURA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3111 N TUSTIN ST STE 100, ORANGE, CA 92865-1751
(818) 241-6780
Mailing address
1055 E COLORADO BLVD STE 560, PASADENA, CA 91106-2380
(818) 241-6780
Taxonomy
Speciality
Code
Description
License number
State
224Z00000X
Occupational Therapy Assistant
Primary
—
—
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
10/21/2017
Last updated
02/24/2021
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