Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2251C2600X | Cardiopulmonary | 17409 | CA |
NPI | 1649526245 |
---|---|
Provider Name | Ms. Kris Ishii |
First Address | San Francisco, CA 94143-0228 |
Second Address | San Francisco, CA 94143-0228 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/08/2012 |
Last Update Date | 01/08/2012 |