Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2084N0400X | Neurologist | MD-12771 | HI |
NPI | 1003924580 |
---|---|
Provider Name | Dr. Beau K. Nakamoto |
First Address | Honolulu, HI 96813-3097 |
Second Address | Honolulu, HI 96813-3009 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/08/2006 |
Last Update Date | 16/03/2012 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
H86187 | (02) | HI |