Provider Demographics
NPI:1790862381
Name:SAITO, SYUCK KI (MD)
Entity Type:Individual
Prefix:DR
First Name:SYUCK KI
Middle Name:
Last Name:SAITO
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 1:868 ULULANI ST STE 110
Mailing Address - Street 2:
Mailing Address - City:HILO
Mailing Address - State:HI
Mailing Address - Zip Code:96720-3913
Mailing Address - Country:US
Mailing Address - Phone:808-961-6054
Mailing Address - Fax:
Practice Address - Street 1:868 ULULANI ST STE 110
Practice Address - Street 2:
Practice Address - City:HILO
Practice Address - State:HI
Practice Address - Zip Code:96720-3913
Practice Address - Country:US
Practice Address - Phone:808-961-6054
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-01
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI11591208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIH77439Medicare UPIN