Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | G76337 | CA |
NPI | 1033129960 |
---|---|
Provider Name | Dr. Susan Keiko Nakamura |
First Address | San Diego, CA 92161-0002 |
Second Address | San Diego, CA 92161-0002 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 09/08/2006 |
Last Update Date | 08/07/2007 |