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General NPI Number Information
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NPI Number | 1124363981
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Entity Type | Organization
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Legal Business Name | SUSAN S. HIRAOKA, DPM, LLC
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Dates
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Enumeration Date | 12/05/2012
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Last Update Date | 12/05/2012
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Provider Practice Location Address
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Address Line | 642 ULUKAHIKI ST SUITE 207
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City | KAILUA
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State | HI
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Zip | 96734-4400
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Country | US
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Telephone | 808-261-9931
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Fax | 808-262-9986
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Provider Business Mailing Address
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Address Line | 642 ULUKAHIKI ST SUITE 207
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City | KAILUA
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State | HI
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Zip | 96734-4400
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Country | US
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Telephone | 808-261-9931
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Fax | 808-262-9986
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Authorized Official
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Title or Position | PHYSICAN
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Name | DR. SUSAN S HIRAOKA
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Credential | D.P.M
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Telephone | 808-261-9931
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 335E00000X
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Taxonomy Name | Prosthetic/Orthotic Supplier
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License Number | PO-155
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License Number State | HI
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