Takako Gwen Iwasaki, M.D.

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

G60009 Issued in CA

Practice address

4201 Torrance Blvd
Suite 340
Torrance, CA 90503-4504

Phone

(310) 540-0079

Fax

(310) 316-6871

NPI assigned

Nov 13, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Dr. Takako Gwen Iwasaki Professional name

Medicare fee-for-service enrollment

Enrolled in CA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of California, Geffen School of Medicine, 1985

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

75 of 100Reported as individual

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1420761600000",
    "number": "1639240237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "SUITE 340",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034504",
            "telephone_number": "310-540-0079",
            "fax_number": "310-316-6871"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 TORRANCE BLVD",
            "address_2": "SUITE 340",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905034504",
            "telephone_number": "310-540-0079",
            "fax_number": "310-316-6871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IWASAKI",
        "first_name": "TAKAKO",
        "middle_name": "GWEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2015-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "CA",
            "license": "G60009",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TAKAKO",
            "last_name": "IWASAKI",
            "middle_name": "GWEN",
            "prefix": "DR.",
            "credential": "M.D.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Francine Fumi Ito, M.D.
• Kacie Ito
• Iveon Solution
• Julie Kyoko Iwasaki, M.D.
• Lisa Iwasaki
• Iyke Associates
• Christopher James Izu, MPT
• Sho Izumi
• J & J Medical Group Inc
• J Christopher Matchison, MD Inc.

• Dermatology Physician in Torrance, CA
• Providers in Torrance, CA by specialty
• Dermatology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 9, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.