Individual
STANLEY KAZUO NAKAMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
431 S BATAVIA ST, STE. 103, ORANGE, CA 92868-3936
(714) 538-6731
(714) 771-8369
Mailing address
PO BOX 14005, ORANGE, CA 92863-1405
(714) 571-5000
(714) 571-5055
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
G43264
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
00G432640
BLUE SHIELD OF CA
—
05
—
00G432640
—
CA
01
—
00G432640 159
CALOPTIMA
—
01
—
053304CA49292
TRAILBLAZER
—
01
—
300035984
RAILROAD MEDICARE
—
Enumeration date
07/18/2005
Last updated
08/15/2008
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