MEDICARE: YUICHIRO DAVID NAKAI M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RE0101X	Endocrinology, Diabetes & Metabolism Physician	A76178	CA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	P00977320	OTHER	CA	RAILROAD MEDICARE

General Provider Information

NPI Number	:	1497739114
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	YUICHIRO DAVID NAKAI M.D.

Provider Business Mailing Address
First Line	:	1162 MONTGOMERY DR STE 300
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95405-4802
Country	:	US
Telephone Number	:	707-890-4250
Fax Number	:

Provider Business Practice Location Address
First Line	:	1162 MONTGOMERY DR STE 300
Second Line	:
City	:	SANTA ROSA
State	:	CA
Zip	:	95405-4802
Country	:	US
Telephone Number	:	707-890-4250
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/06/2005
Last Update Date	:	09/23/2024

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