Basic Information
Provider Information
NPI: 1093911703
EntityType: 2
ReplacementNPI:  
OrganizationName: TED UCHIO, M.D., A PROFESSIONAL CORPORATION
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Mailing Information
Address1: 101 S 1ST ST
Address2: 1000
City: BURBANK
State: CA
PostalCode: 915021938
CountryCode: US
TelephoneNumber: 8188456206
FaxNumber: 8188459774
Practice Location
Address1: 3751 KATELLA AVE
Address2:  
City: LOS ALAMITOS
State: CA
PostalCode: 907203101
CountryCode: US
TelephoneNumber: 5625598131
FaxNumber: 5627993133
Other Information
ProviderEnumerationDate: 06/21/2007
LastUpdateDate: 08/22/2007
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AuthorizedOfficialLastName: UCHIO
AuthorizedOfficialFirstName: TED
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AuthorizedOfficialTitleorPosition: PRESIDENT
AuthorizedOfficialTelephone: 8188456206
IsSoleProprietor:  
IsOrganizationSubpart: N
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AuthorizedOfficialCredential: M.D.
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207L00000XG79270CAY193400000X SINGLE SPECIALTY GROUPAllopathic & Osteopathic PhysiciansAnesthesiology 

No ID Information.


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