Healthcare Provider Details

I. General information

NPI: 1003904749
Provider Name (Legal Business Name): ELIOT NOBUO TOMOMITSU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/10/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

321 N KUAKINI ST SUITE #201
HONOLULU HI
96817-2364
US

IV. Provider business mailing address

321 N KUAKINI ST SUITE #201
HONOLULU HI
96817-2364
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-8611
  • Fax:
Mailing address:
  • Phone: 808-523-8611
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD-3158
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: