MEDICARE: DR. FLORA ISHIHARA DANQUE M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	A62874	CA

General Provider Information

NPI Number	:	1013927425
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. FLORA ISHIHARA DANQUE M.D.

Provider Business Mailing Address
First Line	:	1565 HOTEL CIR S STE 320
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3425
Country	:	US
Telephone Number	:	858-449-7270
Fax Number	:	469-242-9640

Provider Business Practice Location Address
First Line	:	1565 HOTEL CIR S STE 320
Second Line	:
City	:	SAN DIEGO
State	:	CA
Zip	:	92108-3425
Country	:	US
Telephone Number	:	858-449-7270
Fax Number	:	469-242-9640

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/08/2006
Last Update Date	:	02/26/2024

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