Healthcare Provider Details

I. General information

NPI: 1982937744
Provider Name (Legal Business Name): INFECTIOUS DISEASE CONSULTANTS OF HAWAII LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2009
Last Update Date: 12/04/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 S KING ST STE 306
HONOLULU HI
96826-3196
US

IV. Provider business mailing address

2525 S KING ST SUITE 306
HONOLULU HI
96826-3154
US

V. Phone/Fax

Practice location:
  • Phone: 808-949-4747
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number14299
License Number StateHI

VIII. Authorized Official

Name: ERIC H.N. KAJIOKA
Title or Position: MANAGER
Credential: M.D.
Phone: 808-949-4747