Provider Demographics
NPI:1871509752
Name:KOBAYASHI, SHUICHI (MD)
Entity type:Individual
Prefix:DR
First Name:SHUICHI
Middle Name:
Last Name:KOBAYASHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2490 HOSPITAL DR
Mailing Address - Street 2:SUITE 105
Mailing Address - City:MOUNTAIN VIEW
Mailing Address - State:CA
Mailing Address - Zip Code:94040-4122
Mailing Address - Country:US
Mailing Address - Phone:650-962-4630
Mailing Address - Fax:650-962-4631
Practice Address - Street 1:2490 HOSPITAL DR
Practice Address - Street 2:SUITE 105
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4122
Practice Address - Country:US
Practice Address - Phone:650-962-4630
Practice Address - Fax:650-962-4631
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-31
Last Update Date:2007-09-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA83131207R00000X
OH35.081899207R00000X
KY38164207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A831310Medicare ID - Type Unspecified
CAH90197Medicare UPIN