Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 396824 | CA |
Y | 111NI0900X | Internist | 396824 | CA |
NPI | 1003243262 |
---|---|
Provider Name | Marin Nishimura |
First Address | El Cajon, CA 92020-4124 |
Second Address | El Cajon, CA 92020-4124 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2013 |
Last Update Date | 08/07/2021 |