Individual
TETSUO ISHIMORI
Active
Individual
TETSUO ISHIMORI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
A30114
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00A301141
INDIVIDUAL PTAN
CA
01
—
060012146
RAILROAD MEDICARE
CA
01
—
953511288
TAX ID
CA
Enumeration date
06/08/2007
Last updated
05/06/2009
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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