Healthcare Provider Details

I. General information

NPI: 1053575860
Provider Name (Legal Business Name): ZAHRA ISKRA MATHURA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/11/2008
Last Update Date: 09/24/2026
Certification Date: 09/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

221 MAHALANI ST
WAILUKU HI
96793-2526
US

IV. Provider business mailing address

221 MAHALANI ST
WAILUKU HI
96793-2526
US

V. Phone/Fax

Practice location:
  • Phone: 808-244-9056
  • Fax:
Mailing address:
  • Phone: 808-244-9056
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License NumberMD-26988
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License NumberR1553
License Number StateKY
# 3
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License Number01074336A
License Number StateIN
# 4
Primary TaxonomyN
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberM-15256
License Number StateID
# 5
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number01074336A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: