Individual
KENNETH K SHIMOZAKI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3031 W MARCH LN, SUITE 310, STOCKTON, CA 95219-6500
(209) 472-0800
(209) 472-1203
Mailing address
3031 W MARCH LN, SUITE 310, STOCKTON, CA 95219-6500
(209) 472-0800
(209) 472-1203
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
E3847
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
E3847
STATE LICENSE #
CA
05
—
GRE001670
—
CA
Enumeration date
08/29/2006
Last updated
11/19/2007
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