Provider Demographics
NPI:1336331412
Name:HAMAMOTO, JARED TADASHI (MD)
Entity Type:Individual
Prefix:DR
First Name:JARED
Middle Name:TADASHI
Last Name:HAMAMOTO
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:321 N KUAKINI ST
Mailing Address - Street 2:SUITE 306
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2364
Mailing Address - Country:US
Mailing Address - Phone:808-545-1557
Mailing Address - Fax:808-545-5743
Practice Address - Street 1:321 N KUAKINI ST
Practice Address - Street 2:SUITE 306
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2364
Practice Address - Country:US
Practice Address - Phone:808-545-1557
Practice Address - Fax:808-545-5743
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2008-02-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 14157207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI599160-01Medicaid
HIH102810Medicare PIN