Healthcare Provider Details

I. General information

NPI: 1356318208
Provider Name (Legal Business Name): GORDON M. NAKANO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2006
Last Update Date: 01/12/2023
Certification Date: 01/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST #412
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST STE 404
HONOLULU HI
96817-2360
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-8521
  • Fax: 808-539-9337
Mailing address:
  • Phone: 808-772-4743
  • Fax: 808-772-4036

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RH0003X
TaxonomyHematology & Oncology Physician
License NumberMD5112
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: