1447368147 NPI number — JAMES K NAKAMURA MD INC

Table of content: MRS. PRISCILLA M. RENWICK NURSE PRACTITIONER (NPI 1861499592)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1447368147 NPI number — JAMES K NAKAMURA MD INC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
JAMES K NAKAMURA MD INC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1447368147
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
03/20/2013
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1319 PUNAHOU ST
Provider Second Line Business Mailing Address:
SUITE 900
Provider Business Mailing Address City Name:
HONOLULU
Provider Business Mailing Address State Name:
HI
Provider Business Mailing Address Postal Code:
96826-1032
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
808-949-0011
Provider Business Mailing Address Fax Number:
808-943-2536

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1319 PUNAHOU ST
Provider Second Line Business Practice Location Address:
SUITE 900
Provider Business Practice Location Address City Name:
HONOLULU
Provider Business Practice Location Address State Name:
HI
Provider Business Practice Location Address Postal Code:
96826-1032
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
808-949-0011
Provider Business Practice Location Address Fax Number:
808-943-2536
Provider Enumeration Date:
08/25/2006

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
NAKAMURA
Authorized Official First Name:
JAMES
Authorized Official Middle Name:
KATSUYA
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
808-949-0011

Provider Taxonomy Codes

  • Taxonomy code: 208000000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 192520 . This is a "HMN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: MD4630 . This is a "QUEENS HEALTHCARE PLAN" identifier , issued by the state of ( HI ) . This identifiers is of the category "OTHER".
  • Identifier: 01266001 , issued by the state of ( HI ) . This identifiers is of the category "MEDICAID".