Organization
STANLEY H. NAKAMURA D.D.S., INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
LINH NAKAMURA (OFFICE ADMINISTRATOR)
(858) 454-0325
Entity
Organization
Contact information
Practice address
850 PROSPECT ST, SUITE 5, LA JOLLA, CA 92037-4208
(858) 454-0325
(858) 454-5810
Mailing address
850 PROSPECT ST, SUITE 5, LA JOLLA, CA 92037-4208
(858) 454-0325
(858) 454-5810
Taxonomy
Speciality
Code
Description
License number
State
1223P0106X
Oral and Maxillofacial Pathology Dentistry
Primary
30457
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
30457
MEDICARE ID-TYPE UNSPECIFIED
CA
Enumeration date
07/24/2009
Last updated
12/28/2016
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