Provider Demographics
NPI:1467540161
Name:TASH, JEFFREY S (MD)
Entity Type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:S
Last Name:TASH
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:1946 YOUNG ST
Mailing Address - Street 2:SUITE 360
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2150
Mailing Address - Country:US
Mailing Address - Phone:808-973-7320
Mailing Address - Fax:808-973-7325
Practice Address - Street 1:120 KAIULANI AVE
Practice Address - Street 2:LOBBY LEVEL
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-3227
Practice Address - Country:US
Practice Address - Phone:808-971-6000
Practice Address - Fax:808-971-6042
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
HIMD-6832208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIE38697Medicare UPIN