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General NPI Number Information
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NPI Number | 1275746935
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Entity Type | Individual
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Provider Name | BARRY EIICHI SHIBUYA M.D.
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Gender | Male
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Dates
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Enumeration Date | 05/08/2007
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Last Update Date | 11/17/2011
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Provider Practice Location Address
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Address Line | 3775 BEACON AVE SUITE 100
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City | FREMONT
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State | CA
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Zip | 94538-1466
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Country | US
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Telephone | 510-791-1300
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Fax | 510-791-1301
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Provider Business Mailing Address
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Address Line | 3775 BEACON AVE SUITE 100
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City | FREMONT
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State | CA
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Zip | 94538-1466
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Country | US
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Telephone | 510-791-1300
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Fax | 510-791-1301
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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 | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | A72682
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License Number State | CA
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