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General NPI Number Information
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NPI Number | 1922399617
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Entity Type | Organization
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Legal Business Name | GARETH K. NAKASONE, MD INC.
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Dates
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Enumeration Date | 04/28/2011
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Last Update Date | 04/28/2011
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Provider Practice Location Address
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Address Line | 3028 HOLUA WAY
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City | HONOLULU
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State | HI
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Zip | 96819-2932
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Country | US
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Telephone | 808-847-5385
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Fax | 808-847-5387
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Provider Business Mailing Address
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Address Line | PO BOX 17569
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City | HONOLULU
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State | HI
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Zip | 96817-0569
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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 | PRESIDENT
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Name | DR. GARETH KEONI NAKASONE
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Credential | MD
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Telephone | 808-595-3698
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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 | MD - 15319
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License Number State | HI
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