Healthcare Provider Details

I. General information

NPI: 1457364390
Provider Name (Legal Business Name): AKILA SREEDHARAN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/14/2006
Last Update Date: 06/30/2021
Certification Date: 06/30/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 PENSACOLA ST
HONOLULU HI
96814-2118
US

IV. Provider business mailing address

1010 PENSACOLA ST
HONOLULU HI
96814-2118
US

V. Phone/Fax

Practice location:
  • Phone: 808-432-2000
  • Fax:
Mailing address:
  • Phone: 808-432-2000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RA0201X
TaxonomyAllergy & Immunology (Internal Medicine) Physician
License Number15477
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: