Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | A84500 | CA |
N | 207R00000X | Internist | A84500 | CA |
N | 111NI0900X | Internist | A84500 | CA |
N | 207RA0201X | Internist - Allergy & Immunology | A84500 | CA |
NPI | 1215025275 |
---|---|
Provider Name | Dr. Lauren Shin Hiyama |
First Address | Fresno, CA 93720-2457 |
Second Address | Fresno, CA 93720-2457 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/10/2006 |
Last Update Date | 23/06/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
GR0043790 | (05) | CA |
ZZZ21572Z | MEDICARE PTAN FOR ALL OFFICE LOCATIONS UNDER BAZ ALLERGY, ASTHMA & SINUS CENTER (01) | CA |