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General NPI Number Information
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NPI Number | 1053614388
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Entity Type | Organization
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Legal Business Name | EUGENE T TANABE MD INC
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Dates
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Enumeration Date | 12/08/2010
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Last Update Date | 12/08/2010
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Provider Practice Location Address
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Address Line | 98-1079 MOANALUA RD STE 460
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City | AIEA
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State | HI
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Zip | 96701-4723
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Country | US
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Telephone | 808-487-8922
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Fax | 808-486-8466
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Provider Business Mailing Address
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Address Line | 98-1079 MOANALUA RD STE 460
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City | AIEA
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State | HI
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Zip | 96701-4723
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Country | US
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Telephone | 808-487-8922
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Fax | 808-486-8466
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Authorized Official
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Title or Position | PRESIDENT
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Name | EUGENE T TANABE
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Credential | MD
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Telephone | 808-487-8922
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 4072
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License Number State | HI
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