Provider Demographics
NPI:1164608493
Name:ABIGAIL S HARADA M D L L C
Entity Type:Organization
Organization Name:ABIGAIL S HARADA M D L L C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER/PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:ABIGAIL
Authorized Official - Middle Name:SUTIMA
Authorized Official - Last Name:HARADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-523-2020
Mailing Address - Street 1:1585 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4522
Mailing Address - Country:US
Mailing Address - Phone:808-941-3363
Mailing Address - Fax:808-949-0483
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 604
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-523-2020
Practice Address - Fax:808-523-2030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-16
Last Update Date:2022-01-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-14427207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H103431Medicare PIN