Provider Demographics
NPI:1770645988
Name:NAKAMOTO, KAREN J (MD)
Entity Type:Individual
Prefix:MRS
First Name:KAREN
Middle Name:J
Last Name:NAKAMOTO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:82 PUUHONU PLACE
Mailing Address - Street 2:SUITE 208
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720
Mailing Address - Country:US
Mailing Address - Phone:808-935-7765
Mailing Address - Fax:808-969-7990
Practice Address - Street 1:82 PUUHONU PLACE
Practice Address - Street 2:SUITE 208
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720
Practice Address - Country:US
Practice Address - Phone:808-935-7765
Practice Address - Fax:808-969-7990
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-14
Last Update Date:2007-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9461207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI207563OtherHMSA
HI07879801Medicaid
F29395Medicare UPIN
HI07879801Medicaid