MEDICARE: WAYNE K. GOTO, MD, INC.

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	2084P0800X	Psychiatry Physician	MD6118	HI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1740321991
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WAYNE K. GOTO, MD, INC.

Provider Business Mailing Address
First Line	:	1600 KAPIOLANI BLVD STE 1306
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3805
Country	:	US
Telephone Number	:	808-949-7444
Fax Number	:	808-949-6262

Provider Business Practice Location Address
First Line	:	1600 KAPIOLANI BLVD STE 1306
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96814-3805
Country	:	US
Telephone Number	:	808-949-7444
Fax Number	:	808-949-6262

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. WAYNE KAY GOTO
Credential	:	M.D.
Telephone Number	:	808-949-7444

Provider Enumeration Date	:	02/09/2007
Last Update Date	:	10/17/2007

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