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Individual

SHOGO TAKAYAMA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
6080 CENTER DR. 6TH FLOOR SUITE #639, LOS ANGELES, CA 90045
(323) 972-7068
Mailing address
1309 AMHERST AVE APT 104, LOS ANGELES, CA 90025-2030
(323) 559-0276

Taxonomy

Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
11085
CA

Other

Enumeration date
04/13/2023
Last updated
04/13/2023
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