Individual
CAROL YUKIKO NISHIKUBO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2001 SANTA MONICA BLVD STE 560W, SANTA MONICA, CA 90404-2182
(310) 453-5654
(310) 453-6885
Mailing address
2021 SANTA MONICA BLVD, SUITE 400E, SANTA MONICA, CA 90404-2208
(310) 453-5654
(310) 453-6885
Taxonomy
Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
G78746
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G78746
CALIFORNIA LICENSE
CA
05
—
G787460
—
CA
05
—
GR0085740
—
CA
Enumeration date
02/22/2006
Last updated
01/23/2024
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