Provider Demographics
NPI:1821204231
Name:FONG NAKAMURA PARTNERSHIP
Entity Type:Organization
Organization Name:FONG NAKAMURA PARTNERSHIP
Other - Org Name:NATOMAS OPTOMETRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL PARTNER, OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:S
Authorized Official - Last Name:NAKAMURA
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:916-928-8383
Mailing Address - Street 1:3711 TRUXEL RD
Mailing Address - Street 2:SUITE 2
Mailing Address - City:SACRAMENTO
Mailing Address - State:CA
Mailing Address - Zip Code:95834-3610
Mailing Address - Country:US
Mailing Address - Phone:916-928-8383
Mailing Address - Fax:916-928-8380
Practice Address - Street 1:3711 TRUXEL RD
Practice Address - Street 2:SUITE 2
Practice Address - City:SACRAMENTO
Practice Address - State:CA
Practice Address - Zip Code:95834-3610
Practice Address - Country:US
Practice Address - Phone:916-928-8383
Practice Address - Fax:916-928-8380
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-15
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA11927T152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes152W00000XEye and Vision Services ProvidersOptometristGroup - Single Specialty