Individual
DR. HIDEKI ICHINO
Active
Individual
DR. HIDEKI ICHINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
10159
NV
207RI0011X
Interventional Cardiology Physician
Primary
10159
NV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1033136932
—
NV
01
—
11040684
CAQH
—
01
—
CC3194
BLUE CROSS BLUE SHIELD
NV
05
—
XPY197049
—
CA
Enumeration date
07/16/2006
Last updated
09/06/2024
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