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General NPI Number Information
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NPI Number | 1053667220
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Entity Type | Individual
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Provider Name | YUICHI ISHIDA M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/25/2012
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Last Update Date | 07/28/2025
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Provider Practice Location Address
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Address Line | 1 HOAG DR BLDG 31
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 949-764-8258
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Fax | 949-764-1493
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Provider Business Mailing Address
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Address Line | 1 HOAG DR BLDG 31
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City | NEWPORT BEACH
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State | CA
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Zip | 92663-4162
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Country | US
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Telephone | 949-764-8258
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Fax | 949-764-1493
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD-46280
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License Number State | IA
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Taxonomy #2
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | MD-46280
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License Number State | IA
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Taxonomy #3
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number | BP10044691
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 208G00000X
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Taxonomy Name | Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
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License Number | A138253
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License Number State | CA
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