Basic Information
| Provider Information | |||||||||
| NPI: | 1275677585 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | ISHITANI | ||||||||
| FirstName: | ESTHER | ||||||||
| MiddleName: | RO | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1249 S DIAMOND BAR BLVD # 213 | ||||||||
| Address2: | |||||||||
| City: | DIAMOND BAR | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917654122 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3238102604 | ||||||||
| FaxNumber: | 6262277015 | ||||||||
| Practice Location | |||||||||
| Address1: | 3208 ROSEMEAD BLVD FL 2 | ||||||||
| Address2: | |||||||||
| City: | EL MONTE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 917312830 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6262277014 | ||||||||
| FaxNumber: | 6262277015 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 02/19/2007 | ||||||||
| LastUpdateDate: | 12/07/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 12/07/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2084P0800X | A74330 | CA | N | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 2084P0804X | A74330 | CA | Y | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Child & Adolescent Psychiatry |
No ID Information.