Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | MD-9097 | HI |
Y | 2080P0006X | Developmental - Behavioral Pediatrician | MD-9097 | HI |
NPI | 1003903196 |
---|---|
Provider Name | Dr. Jeffrey K. Okamoto |
First Address | Honolulu, HI 96826-2150 |
Second Address | Honolulu, HI 96826-1001 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/10/2006 |
Last Update Date | 03/01/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
F12253 | (02) | HI |