Provider Demographics
NPI:1235625435
Name:TAKEUCHI, ARISA (MD)
Entity Type:Individual
Prefix:DR
First Name:ARISA
Middle Name:
Last Name:TAKEUCHI
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95-1249 MEHEULA PKWY STE 187
Mailing Address - Street 2:
Mailing Address - City:MILILANI
Mailing Address - State:HI
Mailing Address - Zip Code:96789-1791
Mailing Address - Country:US
Mailing Address - Phone:808-625-6444
Mailing Address - Fax:808-623-2552
Practice Address - Street 1:95-1249 MEHEULA PKWY STE 187
Practice Address - Street 2:
Practice Address - City:MILILANI
Practice Address - State:HI
Practice Address - Zip Code:96789-1791
Practice Address - Country:US
Practice Address - Phone:808-625-6444
Practice Address - Fax:808-623-2552
Is Sole Proprietor?:No
Enumeration Date:2018-07-11
Last Update Date:2023-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-23529207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine