Individual
DR. DWIGHT HISAYUKI MUKUNO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6305 COYLE AVE, CARMICHAEL, CA 95608-0438
(916) 961-6920
(916) 966-5063
Mailing address
3160 FOLSOM BLVD, SACRAMENTO, CA 95816-5219
(916) 733-5701
(916) 733-3401
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
G40177
CA
2085R0202X
Diagnostic Radiology Physician
Primary
G40177
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G401770
MEDI-CAL
CA
01
—
P00176690
RAILROAD MEDICARE
—
Enumeration date
06/19/2006
Last updated
08/21/2007
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