Mikio Tachibana, M.D., Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

A35433 Issued in CA

Legal business name

MIKIO TACHIBANA, M.D., INC

Practice address

11100 Warner Ave
Suite 154
Fountain Valley, CA 92708-7506

Phone

(714) 966-2800

Fax

(714) 966-0421

NPI assigned

Sep 7, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mikio Tachibana, M.D.NPI 1598721227

Title

President

Phone

(714) 966-2800

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MIKIO TACHIBANA, M.D. Other name

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Mikio Tachibana, MD

  • Internal Medicine Physician
  • Fountain Valley, CA
  • NPI 1598721227
  Medicare reassignment NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1189123200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1189123200000",
    "number": "1265627731",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 154",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-966-2800",
            "fax_number": "714-966-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11100 WARNER AVE",
            "address_2": "SUITE 154",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927087506",
            "telephone_number": "714-966-2800",
            "fax_number": "714-966-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKIO TACHIBANA, M.D., INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-07",
        "last_updated": "2007-09-07",
        "status": "A",
        "authorized_official_last_name": "TACHIBANA",
        "authorized_official_first_name": "MIKIO",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "714-966-2800",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Internal Medicine",
            "state": "CA",
            "license": "A35433",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00A354330",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MIKIO TACHIBANA, M.D.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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• Internal Medicine Physician in Fountain Valley, CA
• Providers in Fountain Valley, CA by specialty
• Internal Medicine Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.