Provider Demographics
NPI:1073570826
Name:TANJI, TROY MASAO (MD)
Entity Type:Individual
Prefix:DR
First Name:TROY
Middle Name:MASAO
Last Name:TANJI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:94-873 FARRINGTON HWY
Mailing Address - Street 2:SUITE 102
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-3150
Mailing Address - Country:US
Mailing Address - Phone:808-671-3937
Mailing Address - Fax:808-671-3936
Practice Address - Street 1:94-873 FARRINGTON HWY
Practice Address - Street 2:SUITE 102
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-3150
Practice Address - Country:US
Practice Address - Phone:808-671-3937
Practice Address - Fax:808-671-3936
Is Sole Proprietor?:No
Enumeration Date:2006-04-26
Last Update Date:2017-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8313207W00000X
CAG81081207W00000X
HIMD8313207WX0009X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207WX0009XAllopathic & Osteopathic PhysiciansOphthalmologyGlaucoma Specialist
No207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIA206399OtherHMSA (KUAKINI)
HIP0095760OtherMEDICARE RAILROAD
HI07794501Medicaid
HIA206399OtherBLUE CROSS BLUE SHIELD(K)
HI0206391OtherHMSA
HI206391OtherBLUE CROSS BLUE SHIELD
HIMD8313-01OtherMDX
HI1289740001Medicare NSC
HIA206399OtherBLUE CROSS BLUE SHIELD(K)
HI56378Medicare ID - Type Unspecified