Individual
DR. DAVID T KAGEYAMA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
9401 E STOCKTON BLVD, STE 105, ELK GROVE, CA 95624
(916) 686-4937
(916) 686-4469
Mailing address
9401 E STOCKTON BLVD, STE 105, ELK GROVE, CA 95624
(916) 686-4937
(916) 686-4469
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
8255
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0433340001
SUPPLIER #
CA
01
—
GZ604Z
MEDICARE PTAN
—
Enumeration date
04/27/2006
Last updated
10/29/2013
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