Healthcare Provider Details

I. General information

NPI: 1497739114
Provider Name (Legal Business Name): YUICHIRO DAVID NAKAI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/06/2005
Last Update Date: 09/23/2024
Certification Date: 09/23/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1162 MONTGOMERY DR STE 300
SANTA ROSA CA
95405-4802
US

IV. Provider business mailing address

1162 MONTGOMERY DR STE 300
SANTA ROSA CA
95405-4802
US

V. Phone/Fax

Practice location:
  • Phone: 707-890-4250
  • Fax:
Mailing address:
  • Phone: 707-890-4250
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License NumberA76178
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: