Healthcare Provider Details

I. General information

NPI: 1417875923
Provider Name (Legal Business Name): JAMES DIAMOND TSUKAMOTO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2026
Last Update Date: 07/10/2026
Certification Date: 07/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

44-718 ALAKAI ST
KANEOHE HI
96744-2411
US

IV. Provider business mailing address

44-718 ALAKAI ST
KANEOHE HI
96744-2411
US

V. Phone/Fax

Practice location:
  • Phone: 808-722-2920
  • Fax:
Mailing address:
  • Phone: 808-722-2920
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: