Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | 055245 | NY |
Y | 1223S0112X | Oral and Maxillofacial Surgeon | A110357 | CA |
N | 1223S0112X | Oral and Maxillofacial Surgeon | OMS 90 | CA |
NPI | 1063665180 |
---|---|
Provider Name | Dr. Yuko Christine Nakamura |
First Address | Lafayette, CA 94549-5094 |
Second Address | Lafayette, CA 94549-5094 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/11/2008 |
Last Update Date | 19/10/2011 |