Ikeda, Clyde J

Ikeda, Clyde J is an individual health care provider with primary practice located at 1199 Bush St Ste 640, San Francisco CA 94109. He recently has only one registered license in Allopathic & Osteopathic Physicians / Plastic Surgery, which is considered as his primary health care specialty. Ikeda, Clyde J can be contacted via phone (415) 775-1199.

Contact Information

Primary practice address
1199 Bush St Ste 640 San Francisco CA 94109
Phone: (415) 775-1199
Fax: (415) 775-0360
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Plastic Surgery 208200000X G49242 California

Profile Details

NPI number 1548232556
LBN Legal business name Ikeda, Clyde J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 3rd, 2006
Last updated Jul 8th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548232556 NPPES
California MEDICAID 7759618

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