Provider Demographics
NPI:1053483123
Name:MASUDA, ELNA M (MD)
Entity Type:Individual
Prefix:DR
First Name:ELNA
Middle Name:M
Last Name:MASUDA
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 1:888 S KING ST
Mailing Address - Street 2:STRAUB DEPARTMENT OF VASCULAR SURGERY
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-3097
Mailing Address - Country:US
Mailing Address - Phone:808-522-4000
Mailing Address - Fax:808-522-4523
Practice Address - Street 1:888 S KING ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-3009
Practice Address - Country:US
Practice Address - Phone:808-522-4000
Practice Address - Fax:808-522-4523
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2012-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-62102086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI7738444OtherUHA
HI0000078899OtherHMSA
HI059432 01Medicaid
HIE57490Medicare UPIN
HI53895Medicare ID - Type Unspecified