| Doctor Name: | TYE ICHIRO MASAKI |
| NPI Number: | 1013296094 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | AT5466 |
| Business Practice Address: | 11105 Knott Ave Suite A Cypress, CA - 906305137 |
| Business Phone Number: | 7148937399 |
| Business Fax Number: | 7148937389 |
| Mailing Address: | 11105 Knott Ave, Suite A CYPRESS |
| State: | CA |
| Postal Code: | 906305137 |
| Phone Number: | 7148937399 |
| Fax Number: | 7148937389 |
| NPI Enumeration Date: | 08/09/2011 |
| NPI Last Update Date: | 08/09/2011 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2251P0200X |
| License Number: | AT5466 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Taxonomy Classification: | Physical Therapist |
| Taxonomy Specialization: | Pediatrics |
| Taxonomy Definition: | |