Provider Demographics
NPI:1033360771
Name:DE OLIVEIRA, SATIRO NAKAMURA (MD)
Entity type:Individual
Prefix:DR
First Name:SATIRO
Middle Name:NAKAMURA
Last Name:DE OLIVEIRA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:8722 BURTON WAY
Mailing Address - Street 2:102
Mailing Address - City:WEST HOLLYWOOD
Mailing Address - State:CA
Mailing Address - Zip Code:90048-3854
Mailing Address - Country:US
Mailing Address - Phone:267-239-4271
Mailing Address - Fax:
Practice Address - Street 1:5767 W CENTURY BLVD
Practice Address - Street 2:SUITE 400
Practice Address - City:LOS ANGELES
Practice Address - State:CA
Practice Address - Zip Code:90045-5631
Practice Address - Country:US
Practice Address - Phone:310-825-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-30
Last Update Date:2020-09-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
CAA100262208000000X, 2080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA00A1002620Medicaid
CA00A1002620Medicaid