Provider Demographics
NPI:1497739114
Name:NAKAI, YUICHIRO DAVID (MD)
Entity type:Individual
Prefix:
First Name:YUICHIRO
Middle Name:DAVID
Last Name:NAKAI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1162 MONTGOMERY DR STE 300
Mailing Address - Street 2:
Mailing Address - City:SANTA ROSA
Mailing Address - State:CA
Mailing Address - Zip Code:95405-4802
Mailing Address - Country:US
Mailing Address - Phone:707-890-4250
Mailing Address - Fax:
Practice Address - Street 1:1162 MONTGOMERY DR STE 300
Practice Address - Street 2:
Practice Address - City:SANTA ROSA
Practice Address - State:CA
Practice Address - Zip Code:95405-4802
Practice Address - Country:US
Practice Address - Phone:707-890-4250
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2024-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA76178207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
CAP00977320OtherRAILROAD MEDICARE
CAP00977320OtherRAILROAD MEDICARE
CACA112105Medicare PIN
CAFH771ZMedicare PIN