Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD-4882 | HI |
NPI | 1003904921 |
---|---|
Provider Name | Dr. Kenn Saruwatari |
First Address | Aiea, HI 96701-4300 |
Second Address | Aiea, HI 96701-4300 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 23/09/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0000019174 | HMSA (01) | HI |
017841 | (05) | HI |
C98606 | (02) | HI |