Provider Demographics
NPI:1043826647
Name:MURATA-SHIH, KAORI S (MS, RD, CSR)
Entity type:Individual
Prefix:
First Name:KAORI
Middle Name:S
Last Name:MURATA-SHIH
Suffix:
Gender:F
Credentials:MS, RD, CSR
Other - Prefix:
Other - First Name:KAORI
Other - Middle Name:S
Other - Last Name:MURATA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3230 E IMPERIAL HWY STE 300
Mailing Address - Street 2:
Mailing Address - City:BREA
Mailing Address - State:CA
Mailing Address - Zip Code:92821-6751
Mailing Address - Country:US
Mailing Address - Phone:626-236-0124
Mailing Address - Fax:
Practice Address - Street 1:3230 E IMPERIAL HWY STE 300
Practice Address - Street 2:
Practice Address - City:BREA
Practice Address - State:CA
Practice Address - Zip Code:92821-6751
Practice Address - Country:US
Practice Address - Phone:626-236-0124
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-09-18
Last Update Date:2023-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA86081275133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered