Provider Demographics
NPI:1093910176
Name:SHIMIZU, UTA S (MD)
Entity Type:Individual
Prefix:DR
First Name:UTA
Middle Name:S
Last Name:SHIMIZU
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:455 E OCEAN BLVD APT 1010
Mailing Address - Street 2:
Mailing Address - City:LONG BEACH
Mailing Address - State:CA
Mailing Address - Zip Code:90802-4944
Mailing Address - Country:US
Mailing Address - Phone:617-515-7439
Mailing Address - Fax:310-782-1763
Practice Address - Street 1:1000 W CARSON ST
Practice Address - Street 2:
Practice Address - City:TORRANCE
Practice Address - State:CA
Practice Address - Zip Code:90502-2004
Practice Address - Country:US
Practice Address - Phone:310-222-3501
Practice Address - Fax:310-782-1763
Is Sole Proprietor?:No
Enumeration Date:2007-06-18
Last Update Date:2021-12-14
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAA96492207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine