Healthcare Provider Details

I. General information

NPI: 1568687267
Provider Name (Legal Business Name): DAVID EASA MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/16/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1319 PUNAHOU STREET
HONOLULU HI
96826
US

IV. Provider business mailing address

651 ILALO STREET MEB 224E
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-983-6242
  • Fax: 808-983-6240
Mailing address:
  • Phone: 808-692-0887
  • Fax: 808-692-1985

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2080N0001X
TaxonomyNeonatal-Perinatal Medicine Physician
License Number2981
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: