Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207L00000X | Anesthesiologist | 3988 | HI |
NPI | 1003828252 |
---|---|
Provider Name | Vien That Ton |
First Address | Honolulu, HI 96826-1149 |
Second Address | Honolulu, HI 96826-1149 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/08/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
04745301 | (05) | HI |
A53890 | HMSA (01) | HI |
D36248 | (02) |