Provider Demographics
NPI:1306011804
Name:JAN T FUJITA MD INC
Entity Type:Organization
Organization Name:JAN T FUJITA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT CEO
Authorized Official - Prefix:
Authorized Official - First Name:JAN
Authorized Official - Middle Name:T
Authorized Official - Last Name:FUJITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-382-7888
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR
Mailing Address - Street 2:#403
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701
Mailing Address - Country:US
Mailing Address - Phone:808-487-8880
Mailing Address - Fax:808-487-8283
Practice Address - Street 1:99-128 AIEA HEIGHTS DR
Practice Address - Street 2:#403
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701
Practice Address - Country:US
Practice Address - Phone:808-487-8880
Practice Address - Fax:808-487-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-25
Last Update Date:2008-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
07507401Medicare PIN
G03576Medicare UPIN
0000BFBZGMedicare Oscar/Certification