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General NPI Number Information
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NPI Number | 1740318864
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Entity Type | Individual
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Provider Name | FATIMA MALENE IMARA M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/01/2007
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Last Update Date | 05/15/2025
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Provider Practice Location Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-242-2256
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Fax |
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Provider Business Mailing Address
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Address Line | 221 MAHALANI ST
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City | WAILUKU
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State | HI
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Zip | 96793-2526
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Country | US
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Telephone | 808-242-2256
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Fax |
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | A88421
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 18168
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License Number State | WI
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Taxonomy #3
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | MD19623
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License Number State | HI
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