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General NPI Number Information
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NPI Number | 1588619159
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Entity Type | Individual
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Provider Name | MASATO NAGAO M D PH D
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Gender | Male
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Dates
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Enumeration Date | 05/23/2006
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Last Update Date | 01/10/2012
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Provider Practice Location Address
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Address Line | 1001 POTRERO AVENUE RM 3A36
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City | SAN FRANCISCO
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State | CA
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Zip | 94110-3518
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Country | US
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Telephone | 415-206-8811
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Fax | 415-647-3733
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Provider Business Mailing Address
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Address Line | PO BOX 7464
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City | SAN FRANCISCO
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State | CA
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Zip | 94120-7464
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Country | US
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Telephone | 415-206-3103
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Fax | 415-206-3872
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | A91764
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License Number State | CA
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