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1194664839 NPI number — TOMONARI MAXIMILIAN SHIMODA MD

NPI Number: 1194664839
Health Care Provider/Practitioner: TOMONARI MAXIMILIAN SHIMODA MD

Information about “1194664839” NPI (TOMONARI MAXIMILIAN SHIMODA MD) exists in 1194664839 in HTML format HTML  |  1194664839 in plain Text format TXT  |  1194664839 in PDF (Portable Document Format) PDF  |  1194664839 in an XML format XML  formats.

NPI Number : 1194664839 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1194664839",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SHIMODA",
    "FirstName": "TOMONARI",
    "MiddleName": "MAXIMILIAN",
    "NamePrefix": "DR.",
    "NameSuffix": null,
    "Credential": "MD",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "705 VERNY TOWER, 2-14-3 SHIOIRI",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "YOKOSUKA",
    "MailingAddressStateName": "KANAGAWA",
    "MailingAddressPostalCode": "2380042",
    "MailingAddressCountryCode": "JP",
    "MailingAddressTelephoneNumber": null,
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "11234 ANDERSON ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "LOMA LINDA",
    "PracticeLocationAddressStateName": "CA",
    "PracticeLocationAddressPostalCode": "92350-1716",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "877-558-6248",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "03/27/2026",
    "LastUpdateDate": "03/27/2026",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "390200000X",
        "TaxonomyName": "Student in an Organized Health Care Education/Training Program",
        "LicenseNumber": null,
        "LicenseNumberStateCode": null,
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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