ELMIRA MIRA SHISHIM PA NPI 1174777536

NPI Information

NPI: 1174777536
Provider Name: ELMIRA MIRA SHISHIM, PA
Classification: Physician Assistant - 363AM0700X
Entity Type: Individual

Specialization: Medical

PECOS Registration: Yes

Address:
200 S WELLS RD
SUITE 200
VENTURA, CA
ZIP 93004
Phone: (805) 659-1740
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Elmira Mira Shishim, PA is a medical physician assistant in Ventura, CA with 16 years of experience. Elmira Mira Shishim, PA NPI is 1174777536. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

200 S WELLS RD
SUITE 200
VENTURA, CA
ZIP 93004-377
Phone: (805) 659-1740
Fax: (805) 659-9959

The NPI 1174777536 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 11/12/2008 and was last updated on 3/21/2013.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363AM0700X	Physician Assistant	Medical	PA19995	CALIFORNIA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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