Provider Demographics
NPI:1477745545
Name:IMAI, TARYNE ALLYSON (MD)
Entity Type:Individual
Prefix:DR
First Name:TARYNE
Middle Name:ALLYSON
Last Name:IMAI
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 1:1329 LUSITANA ST STE 207
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2411
Mailing Address - Country:US
Mailing Address - Phone:808-686-4600
Mailing Address - Fax:
Practice Address - Street 1:1329 LUSITANA ST STE 207
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2411
Practice Address - Country:US
Practice Address - Phone:808-686-4600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-08-13
Last Update Date:2022-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAA98091208600000X, 208G00000X
HIMD-22871208G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208G00000XAllopathic & Osteopathic PhysiciansThoracic Surgery (Cardiothoracic Vascular Surgery)
No208600000XAllopathic & Osteopathic PhysiciansSurgery