Nicole Shizu Watanabe

Primary specialty

PharmacistTaxonomy code 183500000X

License

77241 Issued in CA

Practice address

25825 Vermont Ave
Harbor City, CA 90710-3518

Phone

(310) 325-5111

NPI assigned

Sep 18, 2017

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

State licenses

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

{
    "created_epoch": "1505692800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1505692800000",
    "number": "1871012286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2353 SANTA FE AVE",
            "city": "TORRANCE",
            "state": "CA",
            "postal_code": "905014318",
            "telephone_number": "310-508-5917"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25825 VERMONT AVE",
            "city": "HARBOR CITY",
            "state": "CA",
            "postal_code": "907103518",
            "telephone_number": "310-325-5111"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WATANABE",
        "first_name": "NICOLE",
        "middle_name": "SHIZU",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-09-18",
        "last_updated": "2017-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "CA",
            "license": "77241",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Quincy C. Wang, MD
• Rick C Wang, OD
• Ziqing Victor Wang, M.D.
• Michael G. Ward, MD
• Keri S. H. Wardwell, M.D.
• Jason Joseph Waterman, M.D.
• Justin Bryan Weir, M.D.
• Richard Franklin Wells, PA
• Robert Weltman, MD
• Western Health Community Clinic

• Pharmacist in Harbor City, CA
• Providers in Harbor City, CA by specialty
• Pharmacist in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 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.