MEDICARE: DR. USHA JAIN MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	208000000X	Pediatrics Physician	4217	HI

General Provider Information

NPI Number	:	1194708297
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. USHA JAIN MD

Provider Business Mailing Address
First Line	:	46-454 HAIKU PLANTATIONS DR
Second Line	:
City	:	KANEOHE
State	:	HI
Zip	:	96744-4207
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	MAKALPA PEDS CLINIC, NAVAL MEDICAL CLINIC
Second Line	:	PEARL HARBOUR
City	:	HONOLULU
State	:	HI
Zip	:	96860
Country	:	US
Telephone Number	:	808-473-1880
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/22/2005
Last Update Date	:	07/08/2007

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