Provider Demographics
NPI:1689934606
Name:MATSUDA, BRENT JITSUO (MD)
Entity Type:Individual
Prefix:DR
First Name:BRENT
Middle Name:JITSUO
Last Name:MATSUDA
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1329 LUSITANA ST STE 107
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2401
Mailing Address - Country:US
Mailing Address - Phone:808-691-5201
Mailing Address - Fax:808-691-5203
Practice Address - Street 1:1329 LUSITANA ST STE 107
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2401
Practice Address - Country:US
Practice Address - Phone:808-691-5201
Practice Address - Fax:808-691-5203
Is Sole Proprietor?:No
Enumeration Date:2012-05-23
Last Update Date:2020-05-28
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Provider Licenses
StateLicense IDTaxonomies
HIMD-18318207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease