Healthcare Provider Details
I. General information
NPI: 1497963367
Provider Name (Legal Business Name): MINORU ADACHI M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y
II. Dates (important events)
Enumeration Date: 05/21/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2155 KALAKAUA AVE SUITE 308
HONOLULU HI
96815-2351
US
IV. Provider business mailing address
300 WAI NANI WAY PH04
HONOLULU HI
96815-3983
US
V. Phone/Fax
- Phone: 808-924-3399
- Fax:
- Phone: 808-923-5890
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QU0200X |
| Taxonomy | Urgent Care Clinic/Center |
| License Number | 12072 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: