Individual
MICHAEL BRUCE MIZOGUCHI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2434 HARRISON AVE, EUREKA, CA 95501-3219
(707) 443-5685
(707) 443-9880
Mailing address
2434 HARRISON AVE, EUREKA, CA 95501-3219
(707) 443-5685
(707) 443-9880
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
A70161
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A701610
—
CA
Enumeration date
07/14/2006
Last updated
08/03/2010
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