Basic Information
Provider Information
NPI: 1568710010
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: OKAJIMA
FirstName: KAZUE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential:  
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
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OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 440 RAYNOLDS ST # 51015
Address2:  
City: EL PASO
State: TX
PostalCode: 799051613
CountryCode: US
TelephoneNumber: 9152154480
FaxNumber: 9152155386
Practice Location
Address1: 4801 ALBERTA AVE
Address2:  
City: EL PASO
State: TX
PostalCode: 79905
CountryCode: US
TelephoneNumber: 9152155200
FaxNumber: 9152158640
Other Information
ProviderEnumerationDate: 08/15/2012
LastUpdateDate: 09/12/2019
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207R00000X252454MAN Allopathic & Osteopathic PhysiciansInternal Medicine 
207R00000XS1202TXN Allopathic & Osteopathic PhysiciansInternal Medicine 
207RC0000XS1202TXY Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease

No ID Information.


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