Individual
MYRA MICHIKO MIZOKAMI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Mailing address
2500 MERCED ST, SAN LEANDRO, CA 94577-4201
(510) 454-1000
Taxonomy
Speciality
Code
Description
License number
State
2080P0207X
Pediatric Hematology & Oncology Physician
Primary
A84880
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
A84880
PHYSICIAN LISCENSE
CA
Enumeration date
02/21/2007
Last updated
12/14/2021
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