Active NPI
Darryl Kitayama, MD
- Orthopaedic Surgery Physician
- Lodi, CA
National Provider Identifier
1639507387
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Orthopaedic Surgery Physician
- License
- A43688
- Practice address
- 2080 Sylvan Way
#1101
Lodi, CA 95242-4487 - Phone
- (209) 481-1699
- NPI assigned
- Oct 16, 2013
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthopaedic Surgery Physician | 207X00000X | A43688 | CA | Primary |
Addresses
Primary practice location
2080 Sylvan Way
#1101
Lodi, CA 95242-4487
Mailing address
2080 Sylvan Way
#1101
Lodi, CA 95242-4487
Phone (209) 481-1699
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
| License | State | Type | Specialty |
|---|---|---|---|
| A43688 | CA | MD | Orthopaedic Surgery Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381881600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381881600000",
"number": "1639507387",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2080 SYLVAN WAY",
"address_2": "#1101",
"city": "LODI",
"state": "CA",
"postal_code": "952424487",
"telephone_number": "209-481-1699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2080 SYLVAN WAY",
"address_2": "#1101",
"city": "LODI",
"state": "CA",
"postal_code": "952424487",
"telephone_number": "209-481-1699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KITAYAMA",
"first_name": "DARRYL",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2013-10-16",
"last_updated": "2013-10-16",
"status": "A"
},
"taxonomies": [
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "CA",
"license": "A43688",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lodi, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 16, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.