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:
Health care specialties
| Specialty | Code | License # | 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548232556 | NPPES |
| California | MEDICAID | 7759618 |
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