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Individual

GAIL SUMIKO SHIBATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
1975 4TH ST, SAN FRANCISCO, CA 94143-2351
(415) 885-7268
Mailing address
FILE 4501, LOS ANGELES, CA 90074-0001
(503) 372-2740
(503) 372-2754

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
G79502
CA
207LP3000X
Pediatric Anesthesiology Physician
G79502
CA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00G795020
BLUE SHIELD OF CA
CA
01
00G795020303
CALOPTIMA
CA
05
00G795050
CA
05
100504234
NV
Enumeration date
06/17/2006
Last updated
04/02/2019
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