| Stanley H. Nakamura D.d.s., Inc. | |
|
850 Prospect St Suite 5 La Jolla CA 92037-4208 | |
| (858) 454-0325 | |
| (858) 454-5810 |
| Full Name | Stanley H. Nakamura D.d.s., Inc. |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Pathology |
| Location | 850 Prospect St, La Jolla, California |
| Authorized Official Name and Position | Linh Nakamura (OFFICE ADMINISTRATOR) |
| Authorized Official Contact | 8584540325 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Stanley H. Nakamura D.d.s., Inc. 850 Prospect St Suite 5 La Jolla CA 92037-4208 Ph: (858) 454-0325 | Stanley H. Nakamura D.d.s., Inc. 850 Prospect St Suite 5 La Jolla CA 92037-4208 Ph: (858) 454-0325 |
| NPI Number | 1669602694 |
|---|---|
| Provider Enumeration Date | 07/24/2009 |
| Last Update Date | 12/28/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669602694 | NPI | - | NPPES |
| 30457 | Other | CA | MEDICARE ID-TYPE UNSPECIFIED |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0106X | Dentist - Oral And Maxillofacial Pathology | 30457 (California) | Primary |
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