Provider Demographics
NPI:1043325459
Name:NAGAMOTO, KIGEN KEN (MD, MPH)
Entity Type:Individual
Prefix:DR
First Name:KIGEN
Middle Name:KEN
Last Name:NAGAMOTO
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5355 ORANGETHORPE AVE
Mailing Address - Street 2:
Mailing Address - City:LA PALMA
Mailing Address - State:CA
Mailing Address - Zip Code:90623-1002
Mailing Address - Country:US
Mailing Address - Phone:559-801-8475
Mailing Address - Fax:
Practice Address - Street 1:5355 ORANGETHORPE AVE
Practice Address - Street 2:
Practice Address - City:LA PALMA
Practice Address - State:CA
Practice Address - Zip Code:90623-1002
Practice Address - Country:US
Practice Address - Phone:805-490-7120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2023-01-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAG724742083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine