Healthcare Provider Details

I. General information

NPI: 1073920922
Provider Name (Legal Business Name): OKAMURA MEDICAL GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/11/2014
Last Update Date: 07/11/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1320 EL CAPITAN DR SUITE 310
DANVILLE CA
94526-6258
US

IV. Provider business mailing address

1320 EL CAPITAN DR SUITE 310
DANVILLE CA
94526-6258
US

V. Phone/Fax

Practice location:
  • Phone: 925-244-9355
  • Fax:
Mailing address:
  • Phone: 925-244-9355
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. NEIL ROBERT OKAMURA
Title or Position: PRESIDENT
Credential: D.O.
Phone: 925-244-9355