Healthcare Provider Details

I. General information

NPI: 1861460636
Provider Name (Legal Business Name): GREGORY AARON RACZNIAK M.D., PH.D., M.PHIL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/09/2006
Last Update Date: 09/04/2026
Certification Date: 09/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

820 MILILANI ST STE 745
HONOLULU HI
96813-2986
US

IV. Provider business mailing address

820 MILILANI ST STE 745
HONOLULU HI
96813-2986
US

V. Phone/Fax

Practice location:
  • Phone: 808-481-6678
  • Fax:
Mailing address:
  • Phone: 808-481-6678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License NumberMD-22330
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD22330
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: