Healthcare Provider Details
I. General information
NPI: 1518966233
Provider Name (Legal Business Name): STEVEN AZUMA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 07/14/2005
Last Update Date: 05/05/2008
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 N KUAKINI ST STE.#709
HONOLULU HI
96817-2364
US
IV. Provider business mailing address
321 N KUAKINI ST STE.#709
HONOLULU HI
96817-2364
US
V. Phone/Fax
- Phone: 808-528-0005
- Fax: 808-526-2236
- Phone: 808-528-0005
- Fax: 808-526-2236
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RC0000X |
| Taxonomy | Cardiovascular Disease Physician |
| License Number | MD5064 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: