Provider Demographics
NPI:1033317946
Name:GESTEUYALA, TAWNI HATSUKO (MD)
Entity Type:Individual
Prefix:DR
First Name:TAWNI
Middle Name:HATSUKO
Last Name:GESTEUYALA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1029 KAPAHULU AVE
Mailing Address - Street 2:SUITE # 409
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96816-1332
Mailing Address - Country:US
Mailing Address - Phone:808-218-7824
Mailing Address - Fax:808-218-7877
Practice Address - Street 1:1029 KAPAHULU AVE
Practice Address - Street 2:SUITE # 409
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96816-1332
Practice Address - Country:US
Practice Address - Phone:808-218-7824
Practice Address - Fax:808-218-7877
Is Sole Proprietor?:Yes
Enumeration Date:2007-07-03
Last Update Date:2011-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-15580208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics