Provider Demographics
NPI:1598850950
Name:SHIMOTAKE, JANET CHI-JANE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:CHI-JANE
Last Name:SHIMOTAKE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:CHIEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2200 OFARRELL ST
Mailing Address - Street 2:
Mailing Address - City:SAN FRANCISCO
Mailing Address - State:CA
Mailing Address - Zip Code:94115-3357
Mailing Address - Country:US
Mailing Address - Phone:415-833-2525
Mailing Address - Fax:
Practice Address - Street 1:2425 GEARY BLVD
Practice Address - Street 2:RM 3145
Practice Address - City:SAN FRANCISCO
Practice Address - State:CA
Practice Address - Zip Code:94115-3358
Practice Address - Country:US
Practice Address - Phone:415-833-2525
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-03
Last Update Date:2011-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83069208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A830690Medicaid
CA00A830690Medicaid