Healthcare Provider Details

I. General information

NPI: 1548603574
Provider Name (Legal Business Name): RAJIV GIRISH RAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/09/2013
Last Update Date: 08/25/2026
Certification Date: 08/25/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813-2413
US

IV. Provider business mailing address

2111 MAUNA PL
HONOLULU HI
96822-2503
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-4311
  • Fax:
Mailing address:
  • Phone: 909-835-0101
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberA133911
License Number StateCA
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberMD-19837
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: