=====================================================
General NPI Number Information
=====================================================
NPI Number | 1720108376
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | HOWARD S. MINAMI, M.D., INC.
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 03/29/2007
-----------------------------------------------------
Last Update Date | 10/30/2007
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1329 LUSITANA ST STE 605
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96813-2431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-599-2500
-----------------------------------------------------
Fax | 808-599-3777
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1329 LUSITANA ST STE 605
-----------------------------------------------------
City | HONOLULU
-----------------------------------------------------
State | HI
-----------------------------------------------------
Zip | 96813-2431
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 808-599-2500
-----------------------------------------------------
Fax | 808-599-3777
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. HOWARD S. MINAMI
-----------------------------------------------------
Credential | M.D.
-----------------------------------------------------
Telephone | 808-599-2500
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 174400000X
-----------------------------------------------------
Taxonomy Name | Specialist
-----------------------------------------------------
License Number | MD4459
-----------------------------------------------------
License Number State | HI
-----------------------------------------------------