Healthcare Provider Details

I. General information

NPI: 1801918222
Provider Name (Legal Business Name): JONAH NISHIHIRA B.A
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/05/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1400 FRANKLIN ST
SAN FRANCISCO CA
94109-5426
US

IV. Provider business mailing address

1400 FRANKLIN ST
SAN FRANCISCO CA
94109-5426
US

V. Phone/Fax

Practice location:
  • Phone: 415-931-8180
  • Fax: 415-931-1323
Mailing address:
  • Phone: 415-931-8180
  • Fax: 415-931-1323

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License NumberHT8224
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: