E. Shibata Podiatry Corp.

Primary specialty

Podiatric Clinic/CenterTaxonomy code 261QP1100X

Legal business name

E. SHIBATA PODIATRY CORP.

Doing business as

Pacific Sun Podiatry

Practice address

6042 Bolsa Ave
Huntington Beach, CA 92647-2443

Phone

(714) 373-8787

NPI assigned

Sep 26, 2023

Organization subpart

No

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

Authorized official

Name

Dr. Emily Sun Shibata, DPMNPI 1700409216

Title

Chief Executive Officer

Phone

(714) 373-8787

Specialties & licenses 1

Addresses

Other names 1

• Pacific Sun Podiatry Doing business as

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Emily Sun Shibata, DPM

  • Podiatrist
  • Los Angeles, CA
  • NPI 1700409216
  NPD Authorized official

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

{
    "created_epoch": "1695686400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1695686400000",
    "number": "1578342788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6042 BOLSA AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6042 BOLSA AVE",
            "city": "HUNTINGTON BEACH",
            "state": "CA",
            "postal_code": "926472443",
            "telephone_number": "714-373-8787"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. SHIBATA PODIATRY CORP.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-09-26",
        "last_updated": "2023-09-26",
        "certification_date": "2023-09-26",
        "status": "A",
        "authorized_official_last_name": "SHIBATA",
        "authorized_official_first_name": "EMILY",
        "authorized_official_middle_name": "SUN",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "714-373-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DPM"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pacific Sun Podiatry",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Podiatric Clinic/Center in Huntington Beach, CA
• Providers in Huntington Beach, CA by specialty
• Podiatric Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2023; 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.