Provider Demographics
NPI:1538276746
Name:HIRABAYASHI, TSUNEO (MD)
Entity type:Individual
Prefix:DR
First Name:TSUNEO
Middle Name:
Last Name:HIRABAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23000 CRENSHAW BLVD
Mailing Address - Street 2:#204
Mailing Address - City:TORRANCE
Mailing Address - State:CA
Mailing Address - Zip Code:90505-3052
Mailing Address - Country:US
Mailing Address - Phone:310-326-5661
Mailing Address - Fax:310-326-0347
Practice Address - Street 1:23000 CRENSHAW BLVD
Practice Address - Street 2:#204
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90505-3052
Practice Address - Country:US
Practice Address - Phone:310-326-5661
Practice Address - Fax:310-326-0347
Is Sole Proprietor?:No
Enumeration Date:2006-08-24
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA025065204C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204C00000XAllopathic & Osteopathic PhysiciansNeuromusculoskeletal Medicine, Sports Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA25065Medicare ID - Type UnspecifiedCA MEDICARE
CAA83170Medicare UPIN