MEDICARE: RONALD Y FUJIMOTO D.O.

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	207Q00000X	Family Medicine Physician	DOS-547	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	:	1962407668
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	RONALD Y FUJIMOTO D.O.

Provider Business Mailing Address
First Line	:	SEVEN WATERFRONT PLAZA
Second Line	:	500 ALA MOANA BLVD., SUITE 300
City	:	HONOLULU
State	:	HI
Zip	:	96813
Country	:	US
Telephone Number	:	808-537-5512
Fax Number	:	808-533-1482

Provider Business Practice Location Address
First Line	:	3-3295 KUHIO HWY
Second Line	:
City	:	LIHUE
State	:	HI
Zip	:	96766-1040
Country	:	US
Telephone Number	:	808-245-8874
Fax Number	:	808-246-9080

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

Provider Enumeration Date	:	06/17/2005
Last Update Date	:	07/08/2007

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