Provider Demographics
NPI:1740386341
Name:STEIN, DAVID (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:
Last Name:STEIN
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 1:1350 S KING ST STE 325
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2008
Mailing Address - Country:US
Mailing Address - Phone:808-591-9116
Mailing Address - Fax:808-591-9655
Practice Address - Street 1:1350 S KING ST STE 325
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-2008
Practice Address - Country:US
Practice Address - Phone:808-591-9116
Practice Address - Fax:808-591-9655
Is Sole Proprietor?:No
Enumeration Date:2006-09-15
Last Update Date:2011-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-57282084P0800X, 2084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
No2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02161401Medicaid
HI061640014OtherCHAMPUS/HMAA/UHA
HI00R0023920OtherBLUE CROSS/ SHIELD/HMSA
HIE50820Medicare UPIN
HI54803Medicare ID - Type Unspecified