Provider Demographics
NPI:1346335601
Name:PAUL Z NAKAZATO MD PC
Entity Type:Organization
Organization Name:PAUL Z NAKAZATO MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT OWNER/PROVIDER
Authorized Official - Prefix:
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:Z
Authorized Official - Last Name:NAKAZATO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:520-326-3999
Mailing Address - Street 1:PO BOX 64536
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85728-4536
Mailing Address - Country:US
Mailing Address - Phone:520-326-3999
Mailing Address - Fax:520-529-6530
Practice Address - Street 1:2001 W ORANGE GROVE RD
Practice Address - Street 2:SUITE 308
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85704-1139
Practice Address - Country:US
Practice Address - Phone:520-326-3999
Practice Address - Fax:520-529-6530
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-04
Last Update Date:2007-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ21265208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZZ74087Medicare PIN