Kristin Shimazaki, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

17105 Issued in CA

Practice address

25043 Narbonne Ave
Lomita, CA 90717-2101

Phone

(310) 373-8120

NPI assigned

Oct 24, 2017

Last updated

Oct 24, 2017By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Marina Raikhel M D a Medical Corporation

  • Family Medicine Physician
  • Lomita, CA
  • NPI 1497739734
  NPD (past)

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

{
    "created_epoch": "1508803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1508803200000",
    "number": "1306358882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16201 WILKIE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905041532",
            "telephone_number": "310-292-1030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25043 NARBONNE AVE",
            "city": "LOMITA",
            "state": "CA",
            "postal_code": "907172101",
            "telephone_number": "310-373-8120"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIMAZAKI",
        "first_name": "KRISTIN",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-10-24",
        "last_updated": "2017-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "CA",
            "license": "17105",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Joann M Smith

• Medical Physician Assistant in Lomita, CA
• Providers in Lomita, CA by specialty
• Medical Physician Assistant in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2017; 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.