Provider Demographics
NPI:1437228541
Name:NOZAKI, JAMES KENJI (MD)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:KENJI
Last Name:NOZAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:388 YPAO RD
Mailing Address - Street 2:
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-3701
Mailing Address - Country:US
Mailing Address - Phone:671-646-8881
Mailing Address - Fax:671-648-2557
Practice Address - Street 1:388 YPAO RD
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3701
Practice Address - Country:US
Practice Address - Phone:671-646-8881
Practice Address - Fax:671-648-2557
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2023-07-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GUM-1272207Q00000X
GUM001272207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAA61493OtherTHE MEDICAL BOARD OF CA
GUG83627Medicare UPIN
GUH51399Medicare PIN