Nakayama, Glenn Shigeru
Nakayama, Glenn Shigeru is an sole proprietor health care provider with primary practice located at 100 E Huntington Dr Suite 102, Alhambra CA 91801-1022. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Nakayama, Glenn Shigeru can be contacted via phone (626) 289-9171.Contact Information
Primary practice address
100 E Huntington Dr Suite 102
Alhambra CA 91801-1022
Phone: (626) 289-9171
Fax: (626) 289-1026
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | OPT6521TPL | California |
Profile Details
| NPI number | 1104897610 |
|---|---|
| LBN Legal business name | Nakayama, Glenn Shigeru |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 1st, 2006 |
| Last updated | Aug 24th, 2010 - about 14 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104897610 | NPPES |
| California | MEDICAID | SD0065210 |
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