Healthcare Provider Details

I. General information

NPI: 1407749112
Provider Name (Legal Business Name): TADA ANESTHESIA SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/31/2025
Last Update Date: 05/31/2025
Certification Date: 05/31/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-673 KUPUOHI ST STE C205
WAIPAHU HI
96797-5373
US

IV. Provider business mailing address

PO BOX 37452
HONOLULU HI
96837-0452
US

V. Phone/Fax

Practice location:
  • Phone: 808-725-0125
  • Fax:
Mailing address:
  • Phone: 808-725-0125
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. TROY TADA
Title or Position: PHYSICIAN, OWNER
Credential: DO
Phone: 808-725-0125