Provider Demographics
NPI:1326161175
Name:TOGASHI, LISA KEIKO (MD)
Entity Type:Individual
Prefix:
First Name:LISA
Middle Name:KEIKO
Last Name:TOGASHI
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 1:98-1079 MOANALUA RD
Mailing Address - Street 2:STE 610
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4716
Mailing Address - Country:US
Mailing Address - Phone:808-488-8845
Mailing Address - Fax:
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:STE 610
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4716
Practice Address - Country:US
Practice Address - Phone:808-488-8845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-09
Last Update Date:2018-06-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI10687207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI499120Medicaid
H55350Medicare ID - Type Unspecified
HI499120Medicaid