Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208000000X | Pediatrician | MD-3158 | HI |
NPI | 1003904749 |
---|---|
Provider Name | Eliot Nobuo Tomomitsu |
First Address | Honolulu, HI 96817-2364 |
Second Address | Honolulu, HI 96817-2364 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/10/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04188701 | (05) | HI |
C97643 | (02) |