Provider Demographics
NPI:1689787996
Name:HARADA, DANIEL M (MD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:M
Last Name:HARADA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:STE 307
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5301
Mailing Address - Country:US
Mailing Address - Phone:808-488-4412
Mailing Address - Fax:808-488-4416
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:STE 307
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-488-4412
Practice Address - Fax:808-488-4416
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2020-09-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI5611207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI022087-01Medicaid
HI022087-02Medicaid
HI00D0024432OtherHMSA-QUEST
HI927OtherALOHACARE
HI00D0024432OtherHMSA
HI990298651-96706-E054OtherTRICARE
HIMD5611-02OtherMDX HAWAII
HI00D0024432OtherHMSA-QUEST
HI927OtherALOHACARE