Provider Demographics
NPI:1245417179
Name:LANCE MICHAEL KURATA, MD, INC.
Entity Type:Organization
Organization Name:LANCE MICHAEL KURATA, MD, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN / PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:LANCE
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KURATA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-587-7998
Mailing Address - Street 1:405 N KUAKINI ST
Mailing Address - Street 2:SUITE 901
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6300
Mailing Address - Country:US
Mailing Address - Phone:808-587-7998
Mailing Address - Fax:808-587-7768
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE 901
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-587-7998
Practice Address - Fax:808-587-7768
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:LANCE MICHAEL KURATA, MD, INC.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 9825261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI08826301Medicaid
HI08826301Medicaid