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General NPI Number Information
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NPI Number | 1245269430
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Entity Type | Individual
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Provider Name | JASON MITSUKI ISA M.D., MSPH
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Gender | Male
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Dates
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Enumeration Date | 07/01/2006
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Last Update Date | 02/05/2008
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Provider Practice Location Address
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Address Line | 321 N KUAKINI ST SUITE 306
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City | HONOLULU
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State | HI
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Zip | 96817-2364
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Country | US
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Telephone | 808-545-1557
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Fax | 808-545-5743
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Provider Business Mailing Address
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Address Line | 321 N KUAKINI ST SUITE 306
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City | HONOLULU
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State | HI
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Zip | 96817-2364
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Country | US
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Telephone | 808-545-1557
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Fax | 808-545-5743
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 13815
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License Number State | HI
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