| Doctor Name: | DR. WAYNE MINORU KISHIMOTO |
| NPI Number: | 1265587703 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | M.D. |
| License Number: | A81757 |
| Business Practice Address: | 27520 Hawthorne Blvd. #220 Rolling Hills Estates, CA - 902743580 |
| Business Phone Number: | 3107064440 |
| Business Fax Number: | 3107064441 |
| Mailing Address: | 27520 Hawthorne Blvd. #220, ROLLING HILLS ESTATES |
| State: | CA |
| Postal Code: | 902743580 |
| Phone Number: | 3107064440 |
| Fax Number: | 3107064441 |
| NPI Enumeration Date: | 01/24/2007 |
| NPI Last Update Date: | 05/01/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 2085R0202X |
| License Number: | A81757 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | CA |
| Taxonomy Type: | Allopathic & Osteopathic Physicians |
| Taxonomy Classification: | Radiology |
| Taxonomy Specialization: | Diagnostic Radiology |
| Taxonomy Definition: | A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |