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General NPI Number Information
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NPI Number | 1578764445
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Entity Type | Organization
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Legal Business Name | HAWAII RESIDENCY PROGRAMS INC
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 09/11/2025
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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
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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 | 1398 FRANK ST.
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City | HONOLULU
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State | HI
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Zip | 96816
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | MD
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Name | MARC MIYASAKI
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Credential |
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Telephone | 808-569-0076
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 14301
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 14301
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License Number State | HI
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