Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225100000X | Physical Therapist | 41042 | CA |
N | 2251G0304X | Physical Therapist - Geriatrics | 41042 | CA |
N | 2251N0400X | Physical Therapist - Neurology | 41042 | CA |
N | 2251S0007X | Physical Therapist - Sports | 41042 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | 41042 | CA |
NPI | 1386061810 |
---|---|
Provider Name | Fumiaki Isshiki |
First Address | Westminster, CA 92683-8066 |
Second Address | Westminster, CA 92683-8066 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 21/03/2014 |
Last Update Date | 09/06/2020 |