Provider Demographics
NPI:1619079951
Name:KAZAMA, RODNEY MITSUO (MD)
Entity Type:Individual
Prefix:DR
First Name:RODNEY
Middle Name:MITSUO
Last Name:KAZAMA
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 1:1380 LUSITANA ST
Mailing Address - Street 2:# 409 QUEENS POB I
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2440
Mailing Address - Country:US
Mailing Address - Phone:808-526-0033
Mailing Address - Fax:808-626-0034
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:# 409 QUEENS POB I
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2440
Practice Address - Country:US
Practice Address - Phone:808-526-0033
Practice Address - Fax:808-626-0034
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-05
Last Update Date:2013-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI4802207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH0000BDLJLMedicare ID - Type Unspecified
C98807Medicare UPIN