Provider Demographics
NPI:1790981884
Name:DAVIDSON, RAYMOND LAU LOKAHI (MD)
Entity Type:Individual
Prefix:
First Name:RAYMOND
Middle Name:LAU LOKAHI
Last Name:DAVIDSON
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 1:2228 LILIHA ST STE 404
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-1654
Mailing Address - Country:US
Mailing Address - Phone:808-386-6851
Mailing Address - Fax:
Practice Address - Street 1:2228 LILIHA ST
Practice Address - Street 2:STE 404
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-1654
Practice Address - Country:US
Practice Address - Phone:808-386-6851
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-25
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI159982084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI686868Medicaid
HIFB788XMedicare PIN