Wayne Minoru Kishimoto, M.D.

Primary specialty

Diagnostic Radiology PhysicianTaxonomy code 2085R0202X

License

A81757 Issued in CA

Practice address

27520 Hawthorne Blvd Ste 220
Rolling Hills Estates, CA 90274-3580

Phone

(310) 706-4440

Fax

(310) 706-4441

NPI assigned

Jan 24, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Focus Medical Imaging

  • Diagnostic Radiology Physician
  • Los Angeles, CA
  • NPI 1700226933
  NPD (past)
• Sunset Radiology, Inc.

  • Diagnostic Radiology Physician
  • Rolling Hills Estates, CA
  • NPI 1114117678
  NPD (past)

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

{
    "created_epoch": "1169596800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640131200000",
    "number": "1265587703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "27520 HAWTHORNE BLVD STE 220",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743580",
            "telephone_number": "310-706-4440",
            "fax_number": "310-706-4441"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "27520 HAWTHORNE BLVD STE 220",
            "city": "ROLLING HILLS ESTATES",
            "state": "CA",
            "postal_code": "902743580",
            "telephone_number": "310-706-4440",
            "fax_number": "310-706-4441"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KISHIMOTO",
        "first_name": "WAYNE",
        "middle_name": "MINORU",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-01-24",
        "last_updated": "2021-12-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "CA",
            "license": "A81757",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "https://careepicwest.kp.org:14430/Interconnect-prodcalgateway/wcf/epic.community.hie/xcpdrespondinggatewaysync.svc/ncalceq",
            "affiliation": "Y",
            "endpointDescription": "Carequality",
            "affiliationName": "The Permanente Medical Group",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "C-CDA",
            "address_1": "700 Lawrence Expy",
            "city": "Santa Clara",
            "state": "CA",
            "country_code": "US",
            "postal_code": "950515173",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Brian Akira Kawai, DDS
• Rebecca Kenkel, O.D.
• Mojdeh Keshavarz, CPHT
• Rashida Khan, MED., LMFT
• Anne Catherine Khodayari, APCC, MT-BC
• Jessica Ariel Kiss, D.O.
• Carolyn Kissel
• Christine Aiko Kuida, MD
• Sepideh Lackpour, L.AC. PH.D.
• Lactation Medical Services PC

• Diagnostic Radiology Physician in Rolling Hills Estates, CA
• Providers in Rolling Hills Estates, CA by specialty
• Diagnostic Radiology Physician in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 22, 2021; 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.