Individual ProviderTad NishimuraAnesthesiologyAllopathic & Osteopathic PhysiciansPractice Address170 Alameda De Las Pulgas, #105, Redwood City, CA 94062-2751(650) 367-5992(415) 460-9927PECOS EnrollmentBased on the most recent information from CMS, provider Tad Nishimura does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1720161672Provider TypeIndividualFull NameNishimura, TadTitleDr.CredentialM.D.GenderMaleSole ProprietorNoEnumeration Date10/23/2006Last Updated7/8/2007Contact InformationPractice LocationPractice Address170 Alameda De Las Pulgas, #105, Redwood City, CA 94062-2751Phone(650) 367-5992FaxUnlisted FaxMailing LocationMailing Address700 Irwin St, #102, San Rafael, CA 94901-3339Phone(415) 460-9927FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode207L00000XPrimaryDescriptionAnesthesiologyAllopathic & Osteopathic PhysiciansLicenseA23652California