Ishida, Victor M
Ishida, Victor M is an individual health care provider with primary practice located at 910 Nw 16Th St Ste 101 , Fruitland ID 83619-2265. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as his primary health care specialty. Ishida, Victor M can be contacted via phone (208) 452-8050.Contact Information
Primary practice address
910 Nw 16Th St Ste 101
Fruitland ID 83619-2265
Phone: (208) 452-8050
Fax: (208) 452-8055
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA423 | Idaho |
Profile Details
| NPI number | 1194894113 |
|---|---|
| LBN Legal business name | Ishida, Victor M |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 6th, 2006 |
| Last updated | Jun 10th, 2022 - about 2 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1194894113 | NPPES |
| Oregon | MEDICAID | 805922100 |
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