Provider Demographics
NPI:1275639973
Name:AMJADI, DARIUS HORMOZ (MD)
Entity Type:Individual
Prefix:DR
First Name:DARIUS
Middle Name:HORMOZ
Last Name:AMJADI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:511
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2421
Mailing Address - Country:US
Mailing Address - Phone:808-599-4433
Mailing Address - Fax:808-531-8884
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:511
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2421
Practice Address - Country:US
Practice Address - Phone:808-599-4433
Practice Address - Fax:808-531-8884
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI16252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02869801Medicaid
HI0000BDCGDMedicare ID - Type Unspecified
HI02869801Medicaid