Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | G048967 | CA |
N | 111NI0900X | Internist | G048967 | CA |
Y | 207RA0001X | Advanced Heart Failure and Transplant Cardiologist | G48967 | CA |
N | 207RC0000X | Internist - Cardiovascular Disease | G048967 | CA |
NPI | 1265520001 |
---|---|
Provider Name | Jaime D Moriguchi |
First Address | Beverly Hills, CA 90211-3103 |
Second Address | Beverly Hills, CA 90211-3103 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 13/10/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00G489670 | (05) | CA |
A51228 | (02) |