Ishibashi, Olivia Taeko
Ishibashi, Olivia Taeko is an individual health care provider with primary practice located at 1920 Colorado Ave , Santa Monica CA 90404-3414. She recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Adolescent Medicine, Allopathic & Osteopathic Physicians / Adult Medicine, Student, Health Care / Student in an Organized Health Care Education/Training Program. Allopathic & Osteopathic Physicians / Family Medicine is her primary health care specialty. Ishibashi, Olivia Taeko can be contacted via phone (310) 319-4711.Contact Information
Primary practice address
1920 Colorado Ave
Santa Monica CA 90404-3414
Phone: (310) 319-4711
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 178419 | California |
| Allopathic & Osteopathic Physicians / Adolescent Medicine | 207QA0000X | 178419 | California |
| Allopathic & Osteopathic Physicians / Adult Medicine | 207QA0505X | 178419 | California |
| Student, Health Care / Student in an Organized Health Care Education/Training Program | 390200000X | ||
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | A178419 | California |
Profile Details
| NPI number | 1033670138 |
|---|---|
| LBN Legal business name | Ishibashi, Olivia Taeko |
| Credentials | MD, MPH |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 29th, 2019 |
| Last updated | Jul 14th, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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