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General NPI Number Information
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NPI Number | 1316132947
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Entity Type | Organization
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Legal Business Name | NANCY SHIBAYAMA, M.D., INC
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Dates
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Enumeration Date | 09/06/2007
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Last Update Date | 09/11/2017
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Provider Practice Location Address
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Address Line | 11795 EDUCATION ST SUITE #209
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City | AUBURN
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State | CA
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Zip | 95602-2454
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Country | US
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Telephone | 530-886-6700
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Fax | 530-886-6701
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Provider Business Mailing Address
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Address Line | 11795 EDUCATION ST SUITE #209
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City | AUBURN
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State | CA
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Zip | 95602-2469
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Country | US
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Telephone | 530-886-6700
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Fax | 530-886-6701
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Authorized Official
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Title or Position | MEDICAL PROVIDER
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Name | DR. NANCY S SHIBAYAMA
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Credential | M.D.
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Telephone | 530-886-6700
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | G77126
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License Number State | CA
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