Provider Demographics
NPI:1447368147
Name:JAMES K NAKAMURA MD INC
Entity type:Organization
Organization Name:JAMES K NAKAMURA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:KATSUYA
Authorized Official - Last Name:NAKAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-949-0011
Mailing Address - Street 1:1319 PUNAHOU ST
Mailing Address - Street 2:SUITE 900
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-1032
Mailing Address - Country:US
Mailing Address - Phone:808-949-0011
Mailing Address - Fax:808-943-2536
Practice Address - Street 1:1319 PUNAHOU ST
Practice Address - Street 2:SUITE 900
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-1032
Practice Address - Country:US
Practice Address - Phone:808-949-0011
Practice Address - Fax:808-943-2536
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-25
Last Update Date:2013-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI192520OtherHMN
HIMD4630OtherQUEENS HEALTHCARE PLAN
HI01266001Medicaid
HIMD4630OtherQUEENS HEALTHCARE PLAN