Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 213E00000X | Podiatrist | PO12402 | HI |
Y | 222Z00000X | Podiatrist | PO12402 | HI |
NPI | 1033158464 |
---|---|
Provider Name | Dr. Ken Sakuda |
First Address | Honolulu, HI 96820-1489 |
Second Address | Honolulu, HI 96813-2405 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/06/2006 |
Last Update Date | 07/11/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
005906 | (05) | HI |
00F005394 | HMSA/BCBS PROVIDER NUMBER (01) | HI |
U367868 | (02) | HI |