Provider Demographics
NPI:1528223971
Name:RUSSELL N HARADA MD INC
Entity Type:Organization
Organization Name:RUSSELL N HARADA MD INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUSSELL
Authorized Official - Middle Name:N
Authorized Official - Last Name:HARADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-486-7775
Mailing Address - Street 1:1585 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1800
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4522
Mailing Address - Country:US
Mailing Address - Phone:808-941-3363
Mailing Address - Fax:808-949-0483
Practice Address - Street 1:98-1079 MOANALUA ROAD
Practice Address - Street 2:SUITE 620
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-4716
Practice Address - Country:US
Practice Address - Phone:808-486-7775
Practice Address - Fax:808-486-5558
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-25
Last Update Date:2008-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HAM777Medicare PIN