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Individual
OLIVIA TAEKO ISHIBASHI
Active
Individual
OLIVIA TAEKO ISHIBASHI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD, MPH
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
A178419
CA
207QA0000X
Adolescent Medicine (Family Medicine) Physician
A178419
CA
207QA0505X
Adult Medicine Physician
A178419
CA
Other
Enumeration date
03/29/2019
Last updated
01/09/2025
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