Provider Demographics
NPI:1134540388
Name:NAKAI, GEORGE SUMIYA (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:SUMIYA
Last Name:NAKAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:GEORGE
Other - Middle Name:SUMIYA
Other - Last Name:NAKAI
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:2784 BLUEBIRD CIRCLE
Mailing Address - Street 2:
Mailing Address - City:COSTA MESA
Mailing Address - State:CA
Mailing Address - Zip Code:92626-4832
Mailing Address - Country:US
Mailing Address - Phone:714-545-3434
Mailing Address - Fax:714-545-3434
Practice Address - Street 1:2784 BLUEBIRD CIR
Practice Address - Street 2:
Practice Address - City:COSTA MESA
Practice Address - State:CA
Practice Address - Zip Code:92626-4832
Practice Address - Country:US
Practice Address - Phone:714-545-3434
Practice Address - Fax:714-545-3434
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-13
Last Update Date:2013-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAAFE17578174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist