=====================================================
General NPI Number Information
=====================================================
NPI Number | 1053737577
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | DEAN H SAITO
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/07/2014
-----------------------------------------------------
Last Update Date | 03/07/2014
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3149 WAIALAE AVE ROOM A
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-554-3250
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3149 WAIALAE AVE ROOM A
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96816
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-554-3250
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 225700000X
-----------------------------------------------------
Taxonomy Name | Massage Therapist
-----------------------------------------------------
License Number | MAT#7130
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------