Healthcare Provider Details

I. General information

NPI: 1437226834
Provider Name (Legal Business Name): VERN KIYOSHI SASAKI MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/29/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 SOUTH KING ST #601
HONOLULU HI
96814
US

IV. Provider business mailing address

1010 SOUTH KING ST #601 VERN K SASAKI MD
HONOLULU HI
96814
US

V. Phone/Fax

Practice location:
  • Phone: 808-591-0077
  • Fax: 808-591-0077
Mailing address:
  • Phone: 808-591-0077
  • Fax: 808-591-0076

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083X0100X
TaxonomyOccupational Medicine Physician
License NumberMD9577
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: