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General NPI Number Information
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NPI Number | 1114194750
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Entity Type | Individual
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Provider Name | LEE NAKAMURA GOERNER MD
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Gender | Female
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Dates
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Enumeration Date | 05/13/2008
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Last Update Date | 07/07/2016
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Provider Practice Location Address
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Address Line | 94-800 UKEE ST #300
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City | WAIPAHU
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State | HI
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Zip | 96797-4044
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Country | US
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Telephone | 808-676-1500
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Fax |
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Provider Business Mailing Address
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Address Line | 3515 NIPO ST
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City | HONOLULU
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State | HI
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Zip | 96822-1142
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Country | US
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Telephone | 504-292-6804
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 18330
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | P1372
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License Number State | TX
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Taxonomy #4
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Taxonomy Code | 2085R0202X
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Taxonomy Name | Diagnostic Radiology Physician
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License Number | 0101254985
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License Number State | VA
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