Healthcare Provider Details
I. General information
NPI: 1922011493
Provider Name (Legal Business Name): JUNJI BERNARD MACHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 08/14/2006
Last Update Date: 10/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
405 N KUAKINI ST SUITE 601
HONOLULU HI
96817-6300
US
IV. Provider business mailing address
405 N KUAKINI ST SUITE 601
HONOLULU HI
96817-6300
US
V. Phone/Fax
- Phone: 808-536-5811
- Fax: 808-596-0370
- Phone: 808-536-5811
- Fax: 808-596-0370
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208600000X |
| Taxonomy | Surgery Physician |
| License Number | MD9040 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: