Healthcare Provider Details

I. General information

NPI: 1619257649
Provider Name (Legal Business Name): RICHARD I TSOU MD INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/22/2011
Last Update Date: 08/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST STE 302
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

PO BOX 25490
HONOLULU HI
96825-0490
US

V. Phone/Fax

Practice location:
  • Phone: 808-537-6968
  • Fax: 808-537-1240
Mailing address:
  • Phone: 808-536-0314
  • Fax: 808-536-0320

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD4848
License Number StateHI

VIII. Authorized Official

Name: RICHARD I TSOU
Title or Position: OWNER
Credential: MD
Phone: 808-537-6968