Provider Demographics
NPI:1497817084
Name:DAVID Y NAKAMURA M D INC
Entity Type:Organization
Organization Name:DAVID Y NAKAMURA M D INC
Other - Org Name:HILO FAMILY MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:Y
Authorized Official - Last Name:NAKAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-934-8989
Mailing Address - Street 1:670 PONAHAWAI STREET
Mailing Address - Street 2:SUITE 216 HILO FAMILY MEDICINE
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-2660
Mailing Address - Country:US
Mailing Address - Phone:808-934-8989
Mailing Address - Fax:808-934-8990
Practice Address - Street 1:670 PONAHAWAI STREET
Practice Address - Street 2:SUITE 216 HILO FAMILY MEDICINE
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-2660
Practice Address - Country:US
Practice Address - Phone:808-934-8989
Practice Address - Fax:808-934-8990
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-14
Last Update Date:2022-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0216192OtherHMSA
HI52423201Medicaid
HI0216192OtherHMSA