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NPI Code Detail

MEDICARE: MRS. KRISTIN SHIMAZAKI PA-C

MEDICARE:  MRS. KRISTIN  SHIMAZAKI  PA-C
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
1363AM0700XMedical Physician Assistant17105CA

General Provider Information

NPI Number : 1306358882
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. KRISTIN SHIMAZAKI PA-C
Provider Business Mailing Address
First Line : 16201 WILKIE AVE
Second Line :
City : TORRANCE
State : CA
Zip : 90504-1532
Country : US
Telephone Number : 310-292-1030
Fax Number :
Provider Business Practice Location Address
First Line : 25043 NARBONNE AVE
Second Line :
City : LOMITA
State : CA
Zip : 90717-2101
Country : US
Telephone Number : 310-373-8120
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/24/2017
Last Update Date : 10/24/2017

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Directions to “ MRS. KRISTIN SHIMAZAKI PA-C” Practice Location

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