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NPI Code Detail

MEDICARE: LOUISE M. LETTICH M.D.

MEDICARE: LOUISE M. LETTICH M.D.
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
12084P0800XPsychiatry Physician51779MA
22084P0800XPsychiatry PhysicianMD8579HI

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
200E0208735OTHERHIHAWAII MEDICAL SVC ASSN

General Provider Information

NPI Number : 1447289194
Entity Type Code : Individual
Provider Name (Legal Business Name) : LOUISE M. LETTICH M.D.
Provider Business Mailing Address
First Line : 361 KAILUA RD APT 8208
Second Line :
City : KAILUA
State : HI
Zip : 96734-2965
Country : US
Telephone Number : 808-429-2581
Fax Number :
Provider Business Practice Location Address
First Line : 755 SCOTT CIR
Second Line :
City : JBPHH
State : HI
Zip : 96853-5399
Country : US
Telephone Number : 808-448-6377
Fax Number : 866-269-3450
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/02/2006
Last Update Date : 12/18/2023

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