Individual
DR. STEVEN SHIMOYAMA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4644 LINCOLN BLVD, SUITE 414, MARINA DEL REY, CA 90292-6313
(310) 821-5723
(310) 821-5828
Mailing address
4644 LINCOLN BLVD, SUITE 414, MARINA DEL REY, CA 90292-6313
(310) 821-5723
(310) 821-5828
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
G47794
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
954233875
EMPLOYER TAX ID
CA
05
—
954233875
—
CA
Enumeration date
07/18/2006
Last updated
01/11/2016
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