Individual
DR. KENNETH T SHIMIZU
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10670 JOHN J HOPKINS DR, SAN DIEGO, CA 92121-1120
(858) 554-4100
Mailing address
10790 RANCHO BERNARDO RD, SAN DIEGO, CA 92127-5705
(760) 599-9545
(760) 599-9549
Taxonomy
Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
G67647
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G67647O
—
CA
Enumeration date
09/07/2005
Last updated
10/26/2017
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