Provider Demographics
NPI:1336672930
Name:ONIZUKA, NAOKO (MD, PHD, MPH)
Entity Type:Individual
Prefix:
First Name:NAOKO
Middle Name:
Last Name:ONIZUKA
Suffix:
Gender:F
Credentials:MD, PHD, MPH
Other - Prefix:
Other - First Name:NAOKO
Other - Middle Name:
Other - Last Name:NISHIYAMA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD, PHD, MPH
Mailing Address - Street 1:420 DELAWARE ST SE
Mailing Address - Street 2:MMC 284
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55455-0341
Mailing Address - Country:US
Mailing Address - Phone:612-626-5454
Mailing Address - Fax:612-625-3238
Practice Address - Street 1:3931 LOUISIANA AVE S
Practice Address - Street 2:
Practice Address - City:ST LOUIS PARK
Practice Address - State:MN
Practice Address - Zip Code:55426-5000
Practice Address - Country:US
Practice Address - Phone:952-993-3230
Practice Address - Fax:952-993-1748
Is Sole Proprietor?:No
Enumeration Date:2017-04-10
Last Update Date:2023-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN67089207X00000X, 207R00000X, 207XX0801X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program