Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251N0400X | Physical Therapist - Neurology | PT28134 | CA |
N | 2251X0800X | Physical Therapist - Orthopedic | PT28134 | CA |
NPI | 1649678558 |
---|---|
Provider Name | Mr. Naohiko Shimada |
First Address | Torrance, CA 90503-2343 |
Second Address | Torrance, CA 90503-2343 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/12/2014 |
Last Update Date | 09/12/2014 |