Healthcare Provider Details

I. General information

NPI: 1881728244
Provider Name (Legal Business Name): TAKESHI OTSUKA L.AC. LMT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/15/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 WARD AVE #600
HONOLULU HI
96814-2131
US

IV. Provider business mailing address

775 KINALAU PL 1602
HONOLULU HI
96813-2656
US

V. Phone/Fax

Practice location:
  • Phone: 808-535-5555
  • Fax: 808-535-5556
Mailing address:
  • Phone: 808-566-6787
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License NumberACU-657
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT-6132
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: