STACEY KIKUMI NAITO


Address: 9900 Balboa Blvd, Suite E, Northridge, CA 91325-5403
Phone: 8187010017

STACEY KIKUMI NAITO (NPI# 1902106560) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1902106560
Entity Type Individual
Full Name STACEY KIKUMI NAITO
Credential D.O.
Practice Address 9900 Balboa Blvd
Suite E
Northridge
CA 91325-5403
Practice Telephone 8187010017
Practice Fax Number 8187010073
Mailing Telephone 8187010017
Mailing Fax Number 8187010073
Enumeration Date 2010-10-29
Last Update Date 2010-10-29
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
N 207NS0135X Dermatology
Specialization: Procedural Dermatology
20A8154 CA Allopathic & Osteopathic Physicians
Y 207Q00000X Family Medicine 20A8154 CA Allopathic & Osteopathic Physicians

Office Location

Street Address 9900 BALBOA BLVD
SUITE E
City NORTHRIDGE
State CA
Zip Code 91325-5403

Providers in the same location

NPI Name Taxonomy Address Enumeration
1073554168 Conrad J R Miranda Iv General Practice 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2006-06-09
1366731762 Raeesy Md Inc Internal Medicine 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2011-04-06
1467753038 Lidia Mendoza Massage Therapist 9900 Balboa Blvd, Suite B, Northridge, CA 91325-5403 2010-11-12
1487822086 Khatul Andkhoy Acupuncturist 9900 Balboa Blvd, Suite B, Northridge, CA 91325-5403 2008-02-15
1215132238 Balboa Medical & Wellness Center,inc. General Practice 9900 Balboa Blvd, Suite E, Northridge, CA 91325-5403 2007-06-19
1629130281 Jae Seob Kim Acupuncturist 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2006-12-13
1124189501 Hee Jong L Choi Acupuncturist 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2006-12-12
1689756132 Northridge Physical Therapy Center,inc Physical Therapist 9900 Balboa Blvd, Suite C, Northridge, CA 91325-5403 2006-10-20
1417044132 Amir Homayon Raeesy-nezhad Internal Medicine 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2006-10-06
1407869928 Great Spirit Medical Group,inc Family Medicine 9900 Balboa Blvd, Suite A, Northridge, CA 91325-5403 2006-08-14
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1396346961 Patricia Yamilet Morales Registered Nurse 18300 Roscoe Blvd Dignity Health- Northridge Hospital M, Northridge, CA 91325 2020-11-02
1790342897 Northridge Kidney Center, LLC Clinic/Center 17710 Roscoe Blvd, Northridge, CA 91325 2019-05-23
1063078376 Ozlem Alper Student in an Organized Health Care Education/Training Program 18497 Dearborn St, Unit 112, Northridge, CA 91325 2019-05-13
1144883489 Better Sober Clinic/Center 9339 Louse Ave, Northridge, CA 91325 2019-04-22
1902383920 Ntr Resources, LLC Pathology 17433 Nordhoff, Northridge, CA 91325 2018-07-23
1043713969 Poly-med Pharmacy Inc Pharmacy 17313 Roscoe Blvd, Northridge, CA 91325 2018-03-16
1982151940 Maria Dakessian Dentist 18250 Roscoe Blvd Ste 345, Northridge, CA 91325 2016-09-07
1487019469 Beshoy Gerges Pharmacist 8254 White Oak Ave Unit 4, Northridge, CA 91325 2015-12-17
1235520305 Gema Bautista Social Worker 8550 Balboa Blvd Ste 216, Northridge, CA 91325 2015-02-11
1083018873 Sosann Haider Pharmacist 18444 Plummer St., Northridge, CA 91325 2014-10-22
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Taxonomy Information

Taxonomy Code 207Q00000X
Grouping Allopathic & Osteopathic Physicians
Classification Family Medicine

Taxonomy Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition]
- Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences.
- Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification
- Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine.

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1356963417 Atalla Medical Group Family Medicine 9839 Belmar Ave, Northridge, CA 91324-1655 2020-05-12
1093163222 Rahul Ahuja Family Medicine 18406 Roscoe Blvd Fl 3, Northridge, CA 91325-4107 2016-05-27
1831539485 Anvar Medical Group Family Medicine 9335 Reseda Blvd Ste 100, Northridge, CA 91324 2013-06-27
1851663744 Maryam Seddigh Tonekaboni Family Medicine 18350 Roscoe Blvd Ste 307, Northridge, CA 91325-4159 2012-02-07
1861761579 Jerome Kornfeld Family Medicine 9800 Melvin Ave, Northridge, CA 91324-1635 2011-12-26
1104106913 George H. Moreland Family Medicine 9816 Bothwell Rd, Northridge, CA 91324-1613 2011-08-24
1437474657 Family Health & Wellness Center Family Medicine 18433 Roscoe Blvd Ste 102, Northridge, CA 91325-4125 2010-03-30
1780912683 James Donald Thomas Family Medicine 9900 Balboa Blvd Ste E, Northridge, CA 91325-5419 2009-12-03
1164655239 Vernon Reginald Chan Family Medicine 17338 Citronia St, Northridge, CA 91325-2013 2009-08-24
1174710164 Jacqueline Masequesmay Family Medicine 18350 Roscoe Blvd Ste 600, Northridge, CA 91325-4187 2007-10-03
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Competitor

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City NORTHRIDGE
Zip Code 91325

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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