Provider Demographics
NPI:1447231873
Name:NAGUWA, STANLEY MASAJI (MD)
Entity Type:Individual
Prefix:
First Name:STANLEY
Middle Name:MASAJI
Last Name:NAGUWA
Suffix:
Gender:M
Credentials:MD
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Other - First Name:
Other - Middle Name:
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Mailing Address - Street 1:451 EAST HEALTH SCIENCES DRIVE
Mailing Address - Street 2:GBSF, UNIVERSITY OF CALIFORNIA
Mailing Address - City:DAVIS
Mailing Address - State:CA
Mailing Address - Zip Code:95616
Mailing Address - Country:US
Mailing Address - Phone:530-752-2884
Mailing Address - Fax:530-754-6047
Practice Address - Street 1:2660 W COVELL BLVD
Practice Address - Street 2:SUITE A
Practice Address - City:DAVIS
Practice Address - State:CA
Practice Address - Zip Code:95616-5645
Practice Address - Country:US
Practice Address - Phone:530-747-3074
Practice Address - Fax:530-792-8556
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2011-08-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CAG33104207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00G331040Medicaid
CA00G331040Medicaid