Healthcare Provider Details

I. General information

NPI: 1386672954
Provider Name (Legal Business Name): CECILY PAIGE TSUCHIYA DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/30/2006
Last Update Date: 06/11/2020
Certification Date: 06/11/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1314 S KING ST SUITE 703
HONOLULU HI
96814-1956
US

IV. Provider business mailing address

1314 S KING ST SUITE 703
HONOLULU HI
96814-1956
US

V. Phone/Fax

Practice location:
  • Phone: 808-593-2121
  • Fax: 808-593-2121
Mailing address:
  • Phone: 808-593-2121
  • Fax: 808-593-2121

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO-143
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License NumberPO-143
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: