Provider Demographics
NPI:1225759228
Name:KARI TANIMOTO, LLC.
Entity Type:Organization
Organization Name:KARI TANIMOTO, LLC.
Other - Org Name:DR. KARI TANIMOTO, DPM
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KARI
Authorized Official - Middle Name:
Authorized Official - Last Name:TANIMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:808-348-2348
Mailing Address - Street 1:PO BOX 971497
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-8205
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST STE 512
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2361
Practice Address - Country:US
Practice Address - Phone:808-348-2348
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-09-07
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1942689548Medicaid