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Michelle R Kishimoto, O.D.

Optometrist in Redondo Beach, CA. Individual provider (NPI-1).

NPI number1417007014
StatusActive
Last updated in NPPESJul 8, 2007

Details

NPI
1417007014
Entity type
Individual (NPI-1)
Name
Michelle R Kishimoto
Credential
O.D.
Sex
Female
Sole proprietor
No
Enumeration date
Jan 12, 2007
Last updated
Jul 8, 2007

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
152W00000X Optometrist11949TCAYes

Practice location

1815 Hawthorne Blvd
Ste 236 Galleria At South Bay
Redondo Beach, CA 90278-3424

Phone 310-370-1618 · Fax 310-371-3126

Mailing address

17868 Hazelwood Ct
Carson, CA 90746-7481

Phone 310-886-0346

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