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General NPI Number Information
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NPI Number | 1518944057
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Entity Type | Individual
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Provider Name | DAVID T KAWANISHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 12/27/2005
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Last Update Date | 10/28/2020
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Provider Practice Location Address
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Address Line | 26800 CROWN VALLEY PKWY SUITE 250
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City | MISSION VIEJO
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State | CA
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Zip | 92691-6384
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Country | US
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Telephone | 949-364-3570
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Fax | 949-364-3430
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Provider Business Mailing Address
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Address Line | 26800 CROWN VALLEY PKWY STE 250
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City | MISSION VIEJO
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State | CA
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Zip | 92691-8038
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Country | US
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Telephone | 949-364-3570
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Fax | 949-364-3430
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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 | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number | G35547
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 207RI0011X
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Taxonomy Name | Interventional Cardiology Physician
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License Number | G35547
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License Number State | CA
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