Provider Demographics
NPI:1114273216
Name:RAYMOND M.TANIGUCHI, M. D. INC.
Entity Type:Organization
Organization Name:RAYMOND M.TANIGUCHI, M. D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:MASAYUKI
Authorized Official - Last Name:TANIGUCHI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-538-6520
Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 415
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2449
Mailing Address - Country:US
Mailing Address - Phone:808-538-6520
Mailing Address - Fax:808-521-7523
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 415
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-538-6520
Practice Address - Fax:808-521-7523
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-07-27
Last Update Date:2012-07-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD1908174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIBDBGJMedicare UPIN