Healthcare Provider Details

I. General information

NPI: 1801933403
Provider Name (Legal Business Name): ISSA ESHIMA M.D., F.A.C.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1199 BUSH ST SUITE 490
SAN FRANCISCO CA
94109-5999
US

IV. Provider business mailing address

1199 BUSH ST SUITE 490
SAN FRANCISCO CA
94109-5999
US

V. Phone/Fax

Practice location:
  • Phone: 415-567-7076
  • Fax: 415-567-5910
Mailing address:
  • Phone: 415-567-7076
  • Fax: 415-567-5910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License NumberG56921
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: