Provider Demographics
NPI:1639271562
Name:HARADA, JANICE (MD)
Entity Type:Individual
Prefix:DR
First Name:JANICE
Middle Name:
Last Name:HARADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2065 S KING ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2225
Mailing Address - Country:US
Mailing Address - Phone:808-949-6451
Mailing Address - Fax:808-949-6452
Practice Address - Street 1:2065 S KING ST
Practice Address - Street 2:SUITE 202
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2225
Practice Address - Country:US
Practice Address - Phone:808-949-6451
Practice Address - Fax:808-949-6452
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-01
Last Update Date:2013-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 9517207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
94-3287935OtherFEIN
HIMD 9517OtherHAWAII STATE LISENCE
G29197Medicare UPIN