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General NPI Number Information
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NPI Number | 1972600344
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Entity Type | Individual
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Provider Name | GREGG K NISHI M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/20/2006
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Last Update Date | 07/21/2023
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Provider Practice Location Address
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Address Line | 9033 WILSHIRE BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1837
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Country | US
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Telephone | 310-858-1242
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Fax | 310-858-1172
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Provider Business Mailing Address
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Address Line | 9033 WILSHIRE BLVD SUITE 200
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City | BEVERLY HILLS
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State | CA
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Zip | 90211-1837
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Country | US
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Telephone | 310-858-1242
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Fax | 310-858-1172
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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 | 13342087-1205
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 63430
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License Number State | AZ
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Taxonomy #3
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Taxonomy Code | 207RC0200X
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Taxonomy Name | Critical Care Medicine (Internal Medicine) Physician
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License Number | 63430
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | A75418
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License Number State | CA
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