MEDICARE: DR. JANICE HARADA M.D.

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	207R00000X	Internal Medicine Physician	MD 9517	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	94-3287935	OTHER		FEIN
2	MD 9517	OTHER	HI	HAWAII STATE LISENCE

General Provider Information

NPI Number	:	1639271562
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANICE HARADA M.D.

Provider Business Mailing Address
First Line	:	2065 S KING ST
Second Line	:	SUITE 202
City	:	HONOLULU
State	:	HI
Zip	:	96826-2225
Country	:	US
Telephone Number	:	808-949-6451
Fax Number	:	808-949-6452

Provider Business Practice Location Address
First Line	:	2065 S KING ST
Second Line	:	SUITE 202
City	:	HONOLULU
State	:	HI
Zip	:	96826-2225
Country	:	US
Telephone Number	:	808-949-6451
Fax Number	:	808-949-6452

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

Provider Enumeration Date	:	09/01/2006
Last Update Date	:	10/30/2013

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Directions to “ DR. JANICE HARADA M.D.” Practice Location

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