Healthcare Provider Details

I. General information

NPI: 1992741136
Provider Name (Legal Business Name): CRAIG TEISEI CHINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/22/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

IV. Provider business mailing address

459 PATTERSON RD
HONOLULU HI
96819-1522
US

V. Phone/Fax

Practice location:
  • Phone: 808-433-0244
  • Fax: 808-433-0281
Mailing address:
  • Phone: 808-433-0244
  • Fax: 808-433-0281

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0300X
TaxonomyGeriatric Medicine (Internal Medicine) Physician
License Number8208
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: