Fujikawa, Mark Alan
Fujikawa, Mark Alan is an individual health care provider with primary practice located at 2414 Shattuck Ave , Berkeley CA 94704-2023. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Fujikawa, Mark Alan can be contacted via phone (510) 843-1228.Contact Information
Primary practice address
2414 Shattuck Ave
Berkeley CA 94704-2023
Phone: (510) 843-1228
Fax: (510) 843-2080
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 5524T | California |
Profile Details
| NPI number | 1366507352 |
|---|---|
| LBN Legal business name | Fujikawa, Mark Alan |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 27th, 2006 |
| Last updated | Jul 9th, 2007 - about 17 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1366507352 | NPPES |
| California | MEDICAID | SD0055240 |
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