Provider Demographics
NPI:1275844631
Name:LESLIE Y ITO MD INC
Entity Type:Organization
Organization Name:LESLIE Y ITO MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:R.N.
Authorized Official - Prefix:
Authorized Official - First Name:NATALIE
Authorized Official - Middle Name:N
Authorized Official - Last Name:HANAI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:808-524-5980
Mailing Address - Street 1:1380 LUSITANA STREET
Mailing Address - Street 2:SUITE 912
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2448
Mailing Address - Country:US
Mailing Address - Phone:808-524-5980
Mailing Address - Fax:808-526-0317
Practice Address - Street 1:1380 LUSITANA STREET
Practice Address - Street 2:SUITE 912
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2448
Practice Address - Country:US
Practice Address - Phone:808-524-5980
Practice Address - Fax:808-526-0317
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-06-30
Last Update Date:2010-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3849174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIC98480Medicare UPIN