Individual
DEAN SHOJI KASHINO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1779 DOMINICAN WAY STE B, SANTA CRUZ, CA 95065-1526
(831) 318-6010
(831) 479-4967
Mailing address
3400 DATA DR, ATTN: CREDENTIALING/PAYER ENROLLMENT, RANCHO CORDOVA, CA 95670-7956
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
G35500
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00G355000
—
CA
01
—
G035500
CA MEDICAL LICENSE
CA
Enumeration date
09/29/2005
Last updated
03/07/2023
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