Healthcare Provider Details

I. General information

NPI: 1669634085
Provider Name (Legal Business Name): JON NARIMASU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/26/2008
Last Update Date: 02/09/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST SUITE #306
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST SUITE #306
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-792-9888
  • Fax: 808-593-9444
Mailing address:
  • Phone: 808-792-9888
  • Fax: 808-593-9444

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License NumberMD17570
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number269944
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: