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Individual

LUCAS I NISHIOKA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
4101 TORRANCE BLVD, TORRANCE, CA 90503
(310) 303-5750
Mailing address
DEPT LA 21552, PASADENA, CA 91185-1552
(949) 263-8620
(949) 263-1639

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
C51191
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00C511910
BLUE SHIELD
CA
05
00C511910
CA
Enumeration date
11/18/2005
Last updated
04/30/2013
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