| Yasuko Kidokoro Md Inc Apc | |
|
4282 Genesee Ave Suite 202 San Diego CA 92117-4989 | |
| (858) 277-9669 | |
| (858) 277-9901 |
| Full Name | Yasuko Kidokoro Md Inc Apc |
|---|---|
| Speciality | General Practice |
| Location | 4282 Genesee Ave, San Diego, California |
| Authorized Official Name and Position | Yasuko Kidokoro (MD) |
| Authorized Official Contact | 8582779669 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Yasuko Kidokoro Md Inc Apc 4282 Genesee Ave Suite 202 San Diego CA 92117-4989 Ph: (858) 277-9669 | Yasuko Kidokoro Md Inc Apc 4282 Genesee Ave Suite 202 San Diego CA 92117-4989 Ph: (858) 277-9669 |
| NPI Number | 1144595000 |
|---|---|
| Provider Enumeration Date | 03/12/2012 |
| Last Update Date | 04/11/2019 |
| Medicare PECOS PAC ID | 7911160593 |
|---|---|
| Medicare Enrollment ID | O20120517000406 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144595000 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | A032727 (California) | Primary |
| Provider Name | Yasuko Kidokoro |
|---|---|
| Provider Type | Practitioner - General Practice |
| Provider Identifiers | NPI Number: 1124130901 PECOS PAC ID: 8628231206 Enrollment ID: I20120517000433 |
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