Provider Demographics
NPI:1164545976
Name:ISHII, SHINYA (MD)
Entity Type:Individual
Prefix:DR
First Name:SHINYA
Middle Name:
Last Name:ISHII
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10945 LE CONTE AVE
Mailing Address - Street 2:STE. 2339
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90095-3000
Mailing Address - Country:US
Mailing Address - Phone:310-825-8253
Mailing Address - Fax:310-794-2199
Practice Address - Street 1:10945 LE CONTE AVE
Practice Address - Street 2:STE. 2339
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90095-3000
Practice Address - Country:US
Practice Address - Phone:310-825-8253
Practice Address - Fax:310-794-2199
Is Sole Proprietor?:No
Enumeration Date:2007-04-08
Last Update Date:2008-04-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA99135207RG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0300XAllopathic & Osteopathic PhysiciansInternal MedicineGeriatric Medicine