Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208D00000X | General Practice Physician | MD-3943 | HI |
NPI | 1043304496 |
---|---|
Provider Name | Dr. James S. Barahal |
First Address | Honolulu, HI 96815-6203 |
Second Address | Honolulu, HI 96815-3227 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 03/10/2014 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D36075 | (02) | HI |