Healthcare Provider Details

I. General information

NPI: 1326734310
Provider Name (Legal Business Name): KAZUSHIGE SHIRAISHI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/13/2023
Last Update Date: 07/03/2026
Certification Date: 07/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

505 PARNASSUS AVE, BOX 0111
SAN FRANCISCO CA
94143
US

IV. Provider business mailing address

505 PARNASSUS AVE, BOX 0111
SAN FRANCISCO CA
94143
US

V. Phone/Fax

Practice location:
  • Phone: 415-476-0753
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberA207023
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: