Healthcare Provider Details

I. General information

NPI: 1336571405
Provider Name (Legal Business Name): JAMES KATSUYA NAKAMURA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/31/2013
Last Update Date: 07/31/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU ST SUITE 900
HONOLULU HI
96826-1001
US

IV. Provider business mailing address

1319 PUNAHOU ST SUITE 900
HONOLULU HI
96826-1001
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-0011
  • Fax: 808-943-2536
Mailing address:
  • Phone: 808-949-0011
  • Fax: 808-943-2536

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number4630
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: