Individual
GAIL PATRICE ISHIYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
300 MEDICAL PLAZA, #B200, LOS ANGELES, CA 90095
(310) 794-1195
(310) 794-7491
Mailing address
5767 W CENTURY BLVD, SUITE 400, LOS ANGELES, CA 90045-5631
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
G80933
CA
208600000X
Surgery Physician
G80933
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G809330
—
CA
Enumeration date
07/13/2006
Last updated
01/17/2020
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