Provider Demographics
NPI:1821381724
Name:NAKAMURA, TAKASHI (MD)
Entity Type:Individual
Prefix:DR
First Name:TAKASHI
Middle Name:
Last Name:NAKAMURA
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 1:1000 AUAHI ST APT 2406
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3365
Mailing Address - Country:US
Mailing Address - Phone:808-636-9762
Mailing Address - Fax:
Practice Address - Street 1:1000 AUAHI ST APT 2406
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3365
Practice Address - Country:US
Practice Address - Phone:808-636-9762
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-05-25
Last Update Date:2023-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 17392207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine