Healthcare Provider Details

I. General information

NPI: 1699684308
Provider Name (Legal Business Name): JOHN HIROKAZU SASAKI APRN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/07/2026
Last Update Date: 09/07/2026
Certification Date: 09/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1315 KALAKAUA AVE APT 1603
HONOLULU HI
96826-1946
US

IV. Provider business mailing address

1315 KALAKAUA AVE APT 1603
HONOLULU HI
96826-1946
US

V. Phone/Fax

Practice location:
  • Phone: 808-386-2966
  • Fax:
Mailing address:
  • Phone: 808-386-2966
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License NumberAPRN-6116
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: