Provider Demographics
NPI:1134245921
Name:OKADA, DARREN (MD)
Entity type:Individual
Prefix:DR
First Name:DARREN
Middle Name:
Last Name:OKADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 260071
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63126-8071
Mailing Address - Country:US
Mailing Address - Phone:314-849-3535
Mailing Address - Fax:844-410-3800
Practice Address - Street 1:4445 MAGNOLIA AVE
Practice Address - Street 2:DEPT OF PATHOLOGY, RIVERSIDE COMMUNITY HOSPITAL
Practice Address - City:RIVERSIDE
Practice Address - State:CA
Practice Address - Zip Code:92501-4135
Practice Address - Country:US
Practice Address - Phone:951-788-3243
Practice Address - Fax:951-788-3633
Is Sole Proprietor?:No
Enumeration Date:2007-03-22
Last Update Date:2019-11-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA55141207ZP0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAE71623Medicare UPIN