Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208800000X | Urologist | A120197 | CA |
NPI | 1063626893 |
---|---|
Provider Name | Leah Y Nakamura |
First Address | Laguna Hills, CA 92653-5134 |
Second Address | Laguna Hills, CA 92653 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/05/2007 |
Last Update Date | 18/05/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1063626893 | (05) | CA |