Healthcare Provider Details

I. General information

NPI: 1841379997
Provider Name (Legal Business Name): TOYOHISA THOMAS ISHII MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/02/2006
Last Update Date: 04/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27007 RED IRONBARK DR
VALLEY CENTER CA
92082-7259
US

IV. Provider business mailing address

27007 RED IRONBARK DR
VALLEY CENTER CA
92082-7259
US

V. Phone/Fax

Practice location:
  • Phone: 760-751-9143
  • Fax:
Mailing address:
  • Phone: 760-751-9143
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberG27949
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: