Healthcare Provider Details
I. General information
NPI: 1699630228
Provider Name (Legal Business Name): PINNIE MEDICAL GROUP PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/16/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1000 AUAHI ST APT 2406
HONOLULU HI
96814-3365
US
IV. Provider business mailing address
1000 AUAHI ST APT 2406
HONOLULU HI
96814-3365
US
V. Phone/Fax
- Phone: 808-258-2370
- Fax:
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207P00000X |
| Taxonomy | Emergency Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
TAKASHI
NAKAMURA
Title or Position: PRESIDENT
Credential: MD
Phone: 808-258-2370