Healthcare Provider Details

I. General information

NPI: 1386783975
Provider Name (Legal Business Name): PETER ELLIOTT DIAMOND M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

932 WARD AVE SUITE 460
HONOLULU HI
96814-2131
US

IV. Provider business mailing address

932 WARD AVE SUITE 460
HONOLULU HI
96814-2131
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-6564
  • Fax: 808-521-1173
Mailing address:
  • Phone: 808-521-6564
  • Fax: 808-521-1173

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207XX0005X
TaxonomySports Medicine (Orthopaedic Surgery) Physician
License NumberMD-3536
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207XX0801X
TaxonomyOrthopaedic Trauma Physician
License NumberMD-3536
License Number StateHI
# 3
Primary TaxonomyY
Taxonomy Code209800000X
TaxonomyLegal Medicine (M.D./D.O.) Physician
License NumberMD-3536
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: