Healthcare Provider Details

I. General information

NPI: 1437261781
Provider Name (Legal Business Name): NEIL R OKAMURA D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 01/30/2020
Certification Date: 01/30/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

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

IV. Provider business mailing address

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

V. Phone/Fax

Practice location:
  • Phone: 925-380-6211
  • Fax: 925-244-0726
Mailing address:
  • Phone: 925-380-6211
  • Fax: 925-244-0726

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number20A6158
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: