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General NPI Number Information
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NPI Number | 1144630732
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Entity Type | Organization
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Legal Business Name | TAKESHI KISHIDA, MD, INC.
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Dates
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Enumeration Date | 05/05/2014
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Last Update Date | 05/05/2014
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Provider Practice Location Address
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Address Line | 1301 PUNCHBOWL ST
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City | HONOLULU
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State | HI
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Zip | 96813-2402
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Country | US
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Telephone | 808-538-9011
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Fax |
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Provider Business Mailing Address
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Address Line | P.O.BOX 61011
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City | HONOLULU
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State | HI
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Zip | 96839-2395
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Country | US
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Telephone | 808-735-9093
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | TAKESHI KISHIDA
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Credential | M.D.
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Telephone | 808-536-5094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | MD-2362
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License Number State | HI
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