NPI Number : 1396977575 Entity Type Code : Individual Provider Name (Legal Business Name) : YURIO MIYAZAWA Provider Business Mailing Address First Line : 3626 BALBOA ST Second Line : City : SAN FRANCISCO State : CA Zip : 94121-2604 Country : US Telephone Number : 415-668-5955 Fax Number : Provider Business Practice Location Address First Line : 3626 BALBOA ST Second Line : City : SAN FRANCISCO State : CA Zip : 94121-2604 Country : US Telephone Number : 415-668-5955 Fax Number : Authorized Official Title or Position : Name : Credential : Telephone Number : Provider Enumeration Date : 08/20/2009 Last Update Date : 09/07/2011