Organization
RUSS T SHIMIZU, M.D., INC.
Active
Organization
RUSS T SHIMIZU, M.D., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. RUSS T SHIMIZU M.D. (OWNER)
(310) 829-5968
Entity
Organization
Contact information
Practice address
2811 WILSHIRE BLVD STE 550, SANTA MONICA, CA 90403-4806
(310) 829-5968
(310) 453-3685
Mailing address
2811 WILSHIRE BLVD STE 550, SANTA MONICA, CA 90403-4806
(310) 323-0026
(310) 453-3685
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
C33305
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00C333052
BLUE SHIELD
CA
01
—
C33305
BLUE CROSS
CA
Enumeration date
06/09/2008
Last updated
02/11/2021
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