Provider Demographics
NPI:1164463436
Name:TAMURA, BRUCE K (MD)
Entity Type:Individual
Prefix:DR
First Name:BRUCE
Middle Name:K
Last Name:TAMURA
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 1:677 ALA MOANA BLVD
Mailing Address - Street 2:STE. 1001
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5417
Mailing Address - Country:US
Mailing Address - Phone:808-469-4923
Mailing Address - Fax:808-587-9507
Practice Address - Street 1:347 NORTH KUAKINI ST
Practice Address - Street 2:HPM-9
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817
Practice Address - Country:US
Practice Address - Phone:808-523-8461
Practice Address - Fax:808-528-1897
Is Sole Proprietor?:No
Enumeration Date:2006-06-09
Last Update Date:2012-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD12083174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI537681-02Medicaid
HIH83346Medicare UPIN
HI55719Medicare ID - Type Unspecified