Provider Demographics
NPI:1447288733
Name:MAKINO, FUMIYO (MS,PT)
Entity type:Individual
Prefix:
First Name:FUMIYO
Middle Name:
Last Name:MAKINO
Suffix:
Gender:F
Credentials:MS,PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:297 DUNSTER DR.
Mailing Address - Street 2:
Mailing Address - City:CAMPBELL
Mailing Address - State:CA
Mailing Address - Zip Code:95008-1101
Mailing Address - Country:US
Mailing Address - Phone:408-850-0592
Mailing Address - Fax:
Practice Address - Street 1:297 DUNSTER DR
Practice Address - Street 2:
Practice Address - City:CAMPBELL
Practice Address - State:CA
Practice Address - Zip Code:95008-1101
Practice Address - Country:US
Practice Address - Phone:408-850-0592
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2009-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT21172225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist