STEWART GEORGE SHIMODA (NPI# 1881646727) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881646727 |
| Entity Type | Individual |
| Full Name | STEWART GEORGE SHIMODA |
| Credential | MD |
| Practice Address |
2501 Harbor Blvd Costa Mesa CA 92626-6143 |
| Mailing Address |
1600 9th Street Room 205 Mailstop 2 3 Sacramento CA 95814-6414 |
| Practice Telephone | 7149575000 |
| Mailing Telephone | 9166542431 |
| Mailing Fax Number | 9166543186 |
| Enumeration Date | 2006-05-17 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208D00000X | General Practice | G21111 | CA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| DEA | AS4555338 | 01 |
| Street Address |
2501 HARBOR BLVD |
| City | COSTA MESA |
| State | CA |
| Zip Code | 92626-6143 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1225089592 | State of California - Department of Developmental Services | Long Term Care Hospital | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2006-05-12 |
| 1639659774 | Afsar Iranmanesh | Pharmacist | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2018-08-17 |
| 1093217531 | Wendy Pang | Pharmacist | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2018-02-28 |
| 1316330459 | Raymond Vagas | Psychologist | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2015-03-13 |
| 1083995930 | Cory Rizzuto | Counselor | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2011-09-06 |
| 1801123021 | Ashley Brooke Gardner | Social Worker | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2009-11-09 |
| 1861655045 | Ying-ling Chao | Social Worker | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2008-07-08 |
| 1316953805 | Michael Kao | Family Medicine | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2006-08-01 |
| 1295759298 | Sienna Sablan Go | Family Medicine | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2006-07-26 |
| 1760404040 | Thanhtuyen Do | Physical Medicine & Rehabilitation | 2501 Harbor Blvd, Department of Oehs Director, Dr. Do, Costa Mesa, CA 92626-6143 | 2006-07-24 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215536982 | Sergio Gutierrez | Behavior Technician | 3303 Harbor Blvd., Suite B8, Costa Mesa, CA 92626 | 2020-10-22 |
| 1780201848 | Kelly Chauvet | Behavior Technician | 1503 Nutmeg Place Suite 110, Costa Mesa, CA 92626 | 2020-07-06 |
| 1316564610 | Timo Rosa | Behavior Technician | 1503 Nutmeg Place, Suite 110, Costa Mesa, CA 92626 | 2020-07-02 |
| 1255966115 | Dalia A Sehweil | Behavior Technician | 1111 Baker, Costa Mesa, CA 92626 | 2020-03-11 |
| 1265071096 | Austin Stotelmyre | Behavior Technician | 1111 Baker St Costa Mesa 92626, Costa Mesa, CA 92626 | 2019-12-26 |
| 1396383022 | The Open Table | Community/Behavioral Health | 151 Kalmus Dr. Bldg C, Suite 100, Costa Mesa, CA 92626 | 2019-12-12 |
| 1851933550 | Jennifer Rivera | Behavior Technician | 1111 Baker St. Unit #a, Costa Mesa, CA 92626 | 2019-10-14 |
| 1962053595 | Peter Na | Behavior Technician | Behavior Functions 3303 Harbor Blvd, Ste B8, Costa Mesa, CA 92626 | 2019-09-25 |
| 1346897147 | Jennifer Lopez | Behavior Technician | 555 Alton Blvd Suite 150, Costa Mesa, CA 92626 | 2019-08-26 |
| 1679134084 | Danny Garcia Chiropractic, PC | Chiropractor | 1503 South Coast Drive, Suite 319, Costa Mesa, CA 92626 | 2019-06-26 |
| Find all providers in zip 92626 | ||||
| Taxonomy Code | 208D00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | General Practice |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568723856 | Allan J. T. Yin | General Practice | 2717 Skylark Cir, Costa Mesa, CA 92626-4844 | 2012-06-03 |
| 1295000602 | Duc Van Duong | General Practice | 2329 Purdue Dr, Costa Mesa, CA 92626-6365 | 2012-03-19 |
| 1003042706 | Harold Kravitz | General Practice | 1809 Hummingbird Dr, Costa Mesa, CA 92626-4835 | 2009-06-09 |
| 1063650844 | Fady Nabil Elias | General Practice | 720 Paularino Ave Ste 100, Costa Mesa, CA 92626-6917 | 2009-02-02 |
| 1316154065 | Sylvia A Preminger Sharma | General Practice | 2701 Fairview Rd, Costa Mesa, CA 92628 | 2007-05-16 |
| 1629158514 | Alvin M Yee | General Practice | 1650 Adams Ave, Costa Mesa, CA 92626-4958 | 2006-10-16 |
| 1609890854 | Roberto Natividad Valenton | General Practice | 301 Victoria St, Costa Mesa, CA 92627-1995 | 2006-07-27 |
| 1033132469 | Roberto N Valenton Md Inc | General Practice | 301 Victoria St, Costa Mesa, CA 92627-1995 | 2006-07-26 |
| 1447204656 | Cathy Cumberland | General Practice | 1190 W Baker St, Ste 100, Costa Mesa, CA 92626-4105 | 2006-05-20 |
| 1962454736 | Cuong Gia Ha | General Practice | 2501 Harbor Blvd, Costa Mesa, CA 92626-6143 | 2006-05-17 |
| Find all providers in COSTA MESA | ||||
| City | COSTA MESA |
| Zip Code | 92626 |
Please comment or provide details below to improve the information on STEWART GEORGE SHIMODA.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.