MEDICARE: RICKY T SUKITA DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	213E00000X	Podiatrist	PO-89	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1053390492
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RICKY T SUKITA DPM

Provider Business Mailing Address
First Line	:	415 DAIRY RD SUITE D
Second Line	:
City	:	KAHULUI
State	:	HI
Zip	:	96732-2348
Country	:	US
Telephone Number	:	808-877-3668
Fax Number	:	808-877-3248

Provider Business Practice Location Address
First Line	:	405 NO. KUAKINI ST.
Second Line	:	SUITE 1111
City	:	HONOLULU
State	:	HI
Zip	:	96817-6301
Country	:	US
Telephone Number	:	808-596-0305
Fax Number	:	808-521-1119

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	01/13/2006
Last Update Date	:	03/14/2023

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Directions to “ RICKY T SUKITA DPM” Practice Location

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