Individual
ANNIE TSUCHIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10602 CHAPMAN AVE STE 200, GARDEN GROVE, CA 92840-3147
(925) 212-3682
Mailing address
91 COSTERO AISLE, IRVINE, CA 92614-5942
(925) 212-3682
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
107408
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
XDP801665466
ANTHEM BLUE CROSS
CA
Enumeration date
06/15/2020
Last updated
08/06/2023
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