Provider Demographics
NPI:1497963367
Name:ADACHI, MINORU (MD)
Entity Type:Individual
Prefix:DR
First Name:MINORU
Middle Name:
Last Name:ADACHI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 WAI NANI WAY
Mailing Address - Street 2:PH04
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96815-3983
Mailing Address - Country:US
Mailing Address - Phone:808-923-5890
Mailing Address - Fax:
Practice Address - Street 1:2155 KALAKAUA AVE
Practice Address - Street 2:SUITE 308
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96815-2351
Practice Address - Country:US
Practice Address - Phone:808-924-3399
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI12072261QU0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH56880OtherPIN
HIA14869Medicare UPIN