Provider Demographics
NPI:1407045883
Name:JAMES T. KAKUDA, MD, LLC
Entity Type:Organization
Organization Name:JAMES T. KAKUDA, MD, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:TAI
Authorized Official - Last Name:KAKUDA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-488-7797
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE #580
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-488-7797
Mailing Address - Fax:808-487-2764
Practice Address - Street 1:98-1079 MOANALUA RD
Practice Address - Street 2:SUITE #580
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4713
Practice Address - Country:US
Practice Address - Phone:808-488-7797
Practice Address - Fax:808-487-2764
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-22
Last Update Date:2007-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI124172086X0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2086X0206XAllopathic & Osteopathic PhysiciansSurgerySurgical OncologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H57338Medicare UPIN