Healthcare Provider Details

I. General information

NPI: 1851592372
Provider Name (Legal Business Name): ASAD MOHAMMAD GHIASUDDIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/31/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1356 LUSITANA ST 4TH FLOOR, DEPT OF PSYCHIATRY
HONOLULU HI
96813-2421
US

IV. Provider business mailing address

1356 LUSITANA ST 4TH FLOOR, DEPT OF PSYCHIATRY
HONOLULU HI
96813-2421
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6000
  • Fax:
Mailing address:
  • Phone: 808-983-6000
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License NumberMD 14022
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License NumberMD 14022
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2084P0804X
TaxonomyChild & Adolescent Psychiatry Physician
License NumberMD 14022
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: