Provider Demographics
NPI:1497919641
Name:ISHIMITSU, DAVID NORIO (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:NORIO
Last Name:ISHIMITSU
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8700 BEVERLY BLVD
Mailing Address - Street 2:TAPER M335
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90048
Mailing Address - Country:US
Mailing Address - Phone:310-423-3419
Mailing Address - Fax:310-423-8335
Practice Address - Street 1:8700 BEVERLY BLVD
Practice Address - Street 2:TAPER M335
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90048
Practice Address - Country:US
Practice Address - Phone:310-423-3419
Practice Address - Fax:310-423-8335
Is Sole Proprietor?:No
Enumeration Date:2008-07-17
Last Update Date:2008-07-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA993832085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology