Provider Demographics
NPI:1588629364
Name:KUMASAKI, DONN Y (MD)
Entity Type:Individual
Prefix:
First Name:DONN
Middle Name:Y
Last Name:KUMASAKI
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 1:321 N KUAKINI ST
Mailing Address - Street 2:SUITE 405
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2364
Mailing Address - Country:US
Mailing Address - Phone:808-522-0190
Mailing Address - Fax:808-523-9068
Practice Address - Street 1:347 N KUAKINI ST
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2306
Practice Address - Country:US
Practice Address - Phone:808-522-0190
Practice Address - Fax:808-523-9068
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2017-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD61062085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI052007-03OtherST DEPT OF PUB SAFETY
HI990157698-96701-B004OtherTRICARE
HIA059459OtherHMSA
HIMD6106OtherQUEENS HEALTHCARE
HI103802483OtherUS MARSHALL SVC-FED DET C
HI990157698-96817-E004OtherTRICARE
HI0000059451OtherQUEST HMSA
HI00A0059459OtherQUEST HMSA
HI108-2145098OtherAETNA
HI300017131OtherPALMETTO GBA
HI0005200701Medicaid
HI05200703Medicaid
HI05200701Medicaid
HI990157698004OtherHI ELEC
HI0059451OtherHMSA
HI052007-01OtherST DEPT OF PUB SAFETY
HI20124380OtherUS LABOR DEPT
HI990157698-96817-E004OtherTRICARE
HI01WCCBH05Medicare PIN