Provider Demographics
NPI:1508904087
Name:FUSION THERAPEUTICS LLC
Entity Type:Organization
Organization Name:FUSION THERAPEUTICS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:KUNIO
Authorized Official - Last Name:UYEDA
Authorized Official - Suffix:
Authorized Official - Credentials:DPT
Authorized Official - Phone:808-366-2740
Mailing Address - Street 1:45-248 POPOKI PL
Mailing Address - Street 2:
Mailing Address - City:KANEOHE
Mailing Address - State:HI
Mailing Address - Zip Code:96744-2353
Mailing Address - Country:US
Mailing Address - Phone:808-366-2740
Mailing Address - Fax:
Practice Address - Street 1:45-248 POPOKI PL
Practice Address - Street 2:
Practice Address - City:KANEOHE
Practice Address - State:HI
Practice Address - Zip Code:96744-2353
Practice Address - Country:US
Practice Address - Phone:808-366-2740
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIPT 783225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Single Specialty