Individual
PAUL T ISHIMINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9300 CAMPUS POINT DRIVE, LA JOLLA, CA 92037
(858) 657-7000
Mailing address
FILE NO. 54826, LOS ANGELES, CA 90074-4826
(888) 486-4380
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
A79142
CA
207PP0204X
Pediatric Emergency Medicine (Emergency Medicine) Physician
Primary
A79142
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A791420
—
CA
Enumeration date
07/11/2006
Last updated
09/18/2020
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