Doctor Name: | DR. KRISTIAN SHINYU GIMA |
NPI Number: | 1629334032 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | D.O. |
License Number: | 20A13550 |
Business Practice Address: | 1438 3rd St Unit B Oakland, CA - 946071806 |
Business Phone Number: | 4156061752 |
Business Fax Number: | |
Mailing Address: | 1438 3rd St Unit B, OAKLAND |
State: | CA |
Postal Code: | 946071806 |
Phone Number: | 4156061752 |
Fax Number: | |
NPI Enumeration Date: | 04/10/2012 |
NPI Last Update Date: | 05/22/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 20A13550 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | CA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |