Provider Demographics
NPI:1215370663
Name:TAKEMOTO, DARCIE MARIE (DO)
Entity Type:Individual
Prefix:DR
First Name:DARCIE
Middle Name:MARIE
Last Name:TAKEMOTO
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:91-6390 KAPOLEI PKWY
Mailing Address - Street 2:STE 200
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706
Mailing Address - Country:US
Mailing Address - Phone:808-691-8200
Mailing Address - Fax:808-691-3955
Practice Address - Street 1:91-6390 KAPOLEI PKWY
Practice Address - Street 2:STE 200
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706
Practice Address - Country:US
Practice Address - Phone:808-691-8200
Practice Address - Fax:808-691-3955
Is Sole Proprietor?:No
Enumeration Date:2013-04-15
Last Update Date:2020-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXBP10047238208000000X
HIDOS-2021208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics