Provider Demographics
NPI:1619139128
Name:MITSUNAGA, LANCE K (MD)
Entity Type:Individual
Prefix:
First Name:LANCE
Middle Name:K
Last Name:MITSUNAGA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1380 LUSITANA ST
Mailing Address - Street 2:SUITE 905
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2449
Mailing Address - Country:US
Mailing Address - Phone:808-522-9633
Mailing Address - Fax:808-522-9646
Practice Address - Street 1:1380 LUSITANA ST
Practice Address - Street 2:SUITE 905
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2449
Practice Address - Country:US
Practice Address - Phone:808-522-9633
Practice Address - Fax:808-522-9646
Is Sole Proprietor?:No
Enumeration Date:2008-06-26
Last Update Date:2017-05-10
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Provider Licenses
StateLicense IDTaxonomies
HI17797207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery