Healthcare Provider Details

I. General information

NPI: 1881387454
Provider Name (Legal Business Name): YUSUKE HIRAO M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/31/2023
Last Update Date: 01/25/2024
Certification Date: 05/31/2023
Deactivation Date: 01/02/2024
Reactivation Date: 01/25/2024

III. Provider practice location address

1301 PUNCHBOWL ST
HONOLULU HI
96813
US

IV. Provider business mailing address

1356 LUSITANA STREET 7TH FLOOR
HONOLULU HI
96813
US

V. Phone/Fax

Practice location:
  • Phone: 808-691-1000
  • Fax:
Mailing address:
  • Phone: 808-586-2910
  • Fax: 808-586-7486

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: