Provider Demographics
NPI:1407819238
Name:JIRO SAEGUSA MD INC
Entity Type:Organization
Organization Name:JIRO SAEGUSA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:JIRO
Authorized Official - Middle Name:
Authorized Official - Last Name:SAEGUSA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-946-0990
Mailing Address - Street 1:1441 KAPIOLANI BLVD
Mailing Address - Street 2:STE 1904
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4408
Mailing Address - Country:US
Mailing Address - Phone:808-946-0990
Mailing Address - Fax:808-946-4001
Practice Address - Street 1:1441 KAPIOLANI BLVD
Practice Address - Street 2:STE 1904
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-4408
Practice Address - Country:US
Practice Address - Phone:808-946-0990
Practice Address - Fax:808-946-4001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD2810208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03732202Medicaid
0004037774OtherAETNA
00B00411099OtherAIU INS CO
MD281002OtherQUEENS HEALTH CARE PLAN
22249101OtherHMA
MD281002OtherQUEENS HEALTH CARE PLAN
HI03732202Medicaid
=========OtherKAISER PERMANENTE INS CO
=========OtherCONNECTICUT GENERAL LIFE
=========OtherTRICARE WEST REGION
=========OtherBENESIGHT UNITED HEALTCAR
=========OtherCALVOS INSURANCE UNDERWIT
=========OtherCIGNA INTERNATIONAL
0004037774OtherAETNA
22249101OtherHMA
=========OtherCIGNA INTERNATIONAL
56184Medicare ID - Type Unspecified