Individual
TED NISHIMURA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
RPH
Contact information
Practice address
1401 AVOCADO AVE STE 104, NEWPORT BEACH, CA 92660-8700
(949) 640-1320
(949) 640-1324
Mailing address
13592 SWEETSHADE WAY, TUSTIN, CA 92782-8379
(714) 975-4677
Taxonomy
Speciality
Code
Description
License number
State
3336C0003X
Community/Retail Pharmacy
Primary
36191
CA
Other
Enumeration date
03/20/2025
Last updated
03/20/2025
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