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Individual
LILLY SHIMAHARA
Active
Individual
LILLY SHIMAHARA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DPM
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3769
CA
213E00000X
Podiatrist
POD3
GU
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
020537
—
AZ
05
—
216220
—
AZ
05
—
520131
—
AZ
01
—
AZ0201750
BC/BS OF ARIZONA
AZ
Enumeration date
08/31/2006
Last updated
03/06/2015
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