=====================================================
General NPI Number Information
=====================================================
NPI Number | 1386884625
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | DANIEL M HARADA, M.D., LLC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 02/26/2009
-----------------------------------------------------
Last Update Date | 09/29/2020
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 98-1247 KAAHUMANU ST STE 307
-----------------------------------------------------
City | AIEA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96701-5301
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-488-4412
-----------------------------------------------------
Fax | 808-488-4416
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 98-1079 MOANALUA RD SUITE 680
-----------------------------------------------------
City | AIEA
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96701-4713
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-487-7700
-----------------------------------------------------
Fax | 808-488-4157
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | LLC OWNER
-----------------------------------------------------
Name | DR. DANIEL M HARADA
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 808-488-4412
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207R00000X
-----------------------------------------------------
Taxonomy Name | Internal Medicine Physician
-----------------------------------------------------
License Number |
-----------------------------------------------------
License Number State |
-----------------------------------------------------