Healthcare Provider Details

I. General information

NPI: 1386030211
Provider Name (Legal Business Name): GLENN N. HAYASHI, M.D, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/07/2015
Last Update Date: 04/07/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S KING ST STE 604
HONOLULU HI
96814-1707
US

IV. Provider business mailing address

1010 S KING ST STE 604
HONOLULU HI
96814-1707
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-1624
  • Fax: 808-597-1626
Mailing address:
  • Phone: 808-597-1624
  • Fax: 808-597-1626

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VG0400X
TaxonomyGynecology Physician
License Number3454
License Number StateHI

VIII. Authorized Official

Name: DR. GLENN HAYASHI
Title or Position: PRESIDENT
Credential: M.D
Phone: 808-597-1624