Otsuka, Mayumi
Otsuka, Mayumi is an individual health care provider with primary practice located at 516 East Nizhoni Blvd , Gallup NM 87301-1337. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Otsuka, Mayumi can be contacted via phone (505) 722-1000.Contact Information
Primary practice address
516 East Nizhoni Blvd
Gallup NM 87301-1337
Phone: (505) 722-1000
Fax: (505) 722-1268
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 0420010593 | Vermont |
Profile Details
| NPI number | 1518954999 |
|---|---|
| LBN Legal business name | Otsuka, Mayumi |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 30th, 2005 |
| Last updated | Apr 29th, 2016 - about 8 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 | 1518954999 | NPPES |
| Colorado | MEDICAID | 24559342 | |
| Colorado | MEDICAID | 811457 | |
| Colorado | MEDICAID | 63139324 |
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