Provider Demographics
NPI:1154740751
Name:NYAKUDARIKA, NATSAI CHARLENE (MD)
Entity type:Individual
Prefix:DR
First Name:NATSAI
Middle Name:CHARLENE
Last Name:NYAKUDARIKA
Suffix:
Gender:
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:9095 RIO SAN DIEGO DR STE 425
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92108-1679
Mailing Address - Country:US
Mailing Address - Phone:858-455-5524
Mailing Address - Fax:858-480-3910
Practice Address - Street 1:9095 RIO SAN DIEGO DR STE 425
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92108-1679
Practice Address - Country:US
Practice Address - Phone:858-455-5524
Practice Address - Fax:858-587-9377
Is Sole Proprietor?:No
Enumeration Date:2014-04-10
Last Update Date:2025-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA139375207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
RES000Medicare UPIN