Provider Demographics
NPI:1447323449
Name:NAKAO, GUY ASAO (RPT LMT)
Entity type:Individual
Prefix:MR
First Name:GUY
Middle Name:ASAO
Last Name:NAKAO
Suffix:
Gender:M
Credentials:RPT LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:278 KILAUEA AVENUE
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2948
Mailing Address - Country:US
Mailing Address - Phone:808-969-7072
Mailing Address - Fax:808-969-7072
Practice Address - Street 1:278 KILAUEA AVENUE
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2948
Practice Address - Country:US
Practice Address - Phone:808-969-7072
Practice Address - Fax:808-969-7072
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI913225100000X
HI4773225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Not Answered225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
E65606OtherHMSA
7175676OtherUNIVERSITY HEALTH ALLIANC
HI101384Medicare ID - Type Unspecified