Individual provider Active NPI

Fred A Nakamura, MD

  • General Practice Physician
  • Long Beach, CA
National Provider Identifier
1164582672
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
General Practice PhysicianTaxonomy code 208D00000X
License
G25618 Issued in CA
Practice address
1250 Bellflower Blvd
SHS
Long Beach, CA 90840-0201
Phone
(562) 985-5146
Fax
(562) 985-8404
NPI assigned
Dec 12, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Physician 208D00000X G25618 CA Primary

Addresses

Primary practice location

1250 Bellflower Blvd
SHS
Long Beach, CA 90840-0201

Mailing address

PO Box 4008
Seal Beach, CA 90740
Phone (562) 985-4771

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
G25618CAMDGeneral Practice Physician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1165881600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164582672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4008",
            "city": "SEAL BEACH",
            "state": "CA",
            "postal_code": "90740",
            "telephone_number": "562-985-4771"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1250 BELLFLOWER BLVD",
            "address_2": "SHS",
            "city": "LONG BEACH",
            "state": "CA",
            "postal_code": "908400201",
            "telephone_number": "562-985-5146",
            "fax_number": "562-985-8404"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NAKAMURA",
        "first_name": "FRED",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208D00000X",
            "taxonomy_group": "",
            "desc": "General Practice",
            "state": "CA",
            "license": "G25618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Beach, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.