Provider Demographics
NPI:1346371960
Name:SHIGIO, LAURI KIMIYE (OD)
Entity Type:Individual
Prefix:DR
First Name:LAURI
Middle Name:KIMIYE
Last Name:SHIGIO
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:325 N WIGET LN
Mailing Address - Street 2:SUITE 120
Mailing Address - City:WALNUT CREEK
Mailing Address - State:CA
Mailing Address - Zip Code:94598-2435
Mailing Address - Country:US
Mailing Address - Phone:925-937-6870
Mailing Address - Fax:925-937-3282
Practice Address - Street 1:325 N WIGET LN
Practice Address - Street 2:SUITE 120
Practice Address - City:WALNUT CREEK
Practice Address - State:CA
Practice Address - Zip Code:94598-2435
Practice Address - Country:US
Practice Address - Phone:925-937-6870
Practice Address - Fax:925-937-3282
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA10732T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist