Healthcare Provider Details

I. General information

NPI: 1316929011
Provider Name (Legal Business Name): DANIEL F BRANDT M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/17/2005
Last Update Date: 12/11/2023
Certification Date: 12/11/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

405 N KUAKINI ST STE 1104
HONOLULU HI
96817-6301
US

IV. Provider business mailing address

405 N KUAKINI ST STE 1104
HONOLULU HI
96817-6301
US

V. Phone/Fax

Practice location:
  • Phone: 808-528-4577
  • Fax: 808-888-0988
Mailing address:
  • Phone: 808-528-4577
  • Fax: 808-888-0988

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberA88724
License Number StateCA
# 2
Primary TaxonomyN
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number036.116317
License Number StateIL
# 3
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License NumberMD-15707
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: