Provider Demographics
NPI:1053843235
Name:STERLING NAKAMURA MD
Entity Type:Organization
Organization Name:STERLING NAKAMURA MD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:STERLING
Authorized Official - Middle Name:
Authorized Official - Last Name:NAKAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:650-962-4928
Mailing Address - Street 1:PO BOX 60579
Mailing Address - Street 2:
Mailing Address - City:PALO ALTO
Mailing Address - State:CA
Mailing Address - Zip Code:94306-0579
Mailing Address - Country:US
Mailing Address - Phone:650-962-4928
Mailing Address - Fax:650-539-0242
Practice Address - Street 1:2500 HOSPITAL DR BLDG 3
Practice Address - Street 2:
Practice Address - City:MOUNTAIN VIEW
Practice Address - State:CA
Practice Address - Zip Code:94040-4106
Practice Address - Country:US
Practice Address - Phone:650-962-4928
Practice Address - Fax:650-539-0242
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-28
Last Update Date:2017-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA906092084P0800X
CA21386364SP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatryGroup - Single Specialty
No364SP0808XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental HealthGroup - Single Specialty