Basic Information
| Provider Information | |||||||||
| NPI: | 1699735191 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HIROTA | ||||||||
| FirstName: | DAVID | ||||||||
| MiddleName: | MASAO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 2699 ATLANTIC AVE | ||||||||
| Address2: | |||||||||
| City: | LONG BEACH | ||||||||
| State: | CA | ||||||||
| PostalCode: | 908062710 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5624263333 | ||||||||
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| Practice Location | |||||||||
| Address1: | 3401 CENTRE LAKE DR STE 512 | ||||||||
| Address2: | |||||||||
| City: | ONTARIO | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917611201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 9095660445 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 03/27/2006 | ||||||||
| LastUpdateDate: | 10/24/2019 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A065105 | CA | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
No ID Information.