Individual
DR. GLENN KIKUYA IKAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
575 E LOCUST AVE STE 311, FRESNO, CA 93720-2928
(559) 256-0100
(559) 256-1081
Mailing address
575 E LOCUST AVE STE 311, FRESNO, CA 93720-2928
(559) 256-0100
(559) 256-1081
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
G76092
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G76092
STATE MEDICAL LICENSE
CA
Enumeration date
05/23/2007
Last updated
07/08/2007
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