Organization Active NPI

George Shimomura MD Inc

  • Gynecology Physician
  • Aiea, HI
National Provider Identifier
1073733176
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gynecology PhysicianTaxonomy code 207VG0400X
License
MD1578
Legal business name
GEORGE SHIMOMURA MD INC
Practice address
99-128 Aiea Heights Drive
Suite 504
Aiea, HI 96701-3938
Phone
(808) 487-2497
Fax
(808) 487-2494
NPI assigned
Apr 30, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
George Shimomura, MDNPI 1528283397
Title
President
Phone
(808) 487-2497

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207VG0400X MD1578 Primary

Addresses

Primary practice location

99-128 Aiea Heights Drive
Suite 504
Aiea, HI 96701-3938

Mailing address

99-128 Aiea Heights Drive
Suite 504
Aiea, HI 96701-3938
Phone (808) 487-2497

Other identifiers 2

IdentifierTypeStateIssuer
33340OtherHIHAWAII MEDICAL SERVICE AS
02995201MedicaidHI

National Provider Directory

National Provider Directory

Locations

99-128 Aiea Heights Dr
Ste 504
Aiea, HI 96701
Phone (808) 487-2497

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1177891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1073733176",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DRIVE",
            "address_2": "SUITE 504",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013938",
            "telephone_number": "808-487-2497",
            "fax_number": "808-487-2494"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DRIVE",
            "address_2": "SUITE 504",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013938",
            "telephone_number": "808-487-2497",
            "fax_number": "808-487-2494"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GEORGE SHIMOMURA MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-30",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "SHIMOMURA",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-487-2497",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": null,
            "license": "MD1578",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "HAWAII MEDICAL SERVICE AS",
            "identifier": "33340",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02995201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Aiea, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.