Individual
PAUL MICHIHIDE KANZAWA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CO
Taxonomy
Speciality
Code
Description
License number
State
222Z00000X
Orthotist
Primary
00031048
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GXC000190
MEDICAL
CA
Enumeration date
08/25/2020
Last updated
08/25/2020
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