Provider Demographics
NPI:1801843842
Name:HARADA, ANN SORAYA (MD)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:SORAYA
Last Name:HARADA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1585 KAPIOLANI BLVD STE 1800
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-4500
Mailing Address - Country:US
Mailing Address - Phone:808-941-3363
Mailing Address - Fax:808-949-0483
Practice Address - Street 1:1329 LUSITANA ST STE 600
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2434
Practice Address - Country:US
Practice Address - Phone:808-773-8678
Practice Address - Fax:808-773-8679
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-27
Last Update Date:2022-02-02
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
HI18282207R00000X
NV11809207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NV100509207Medicaid
HIH107237Medicare PIN
NV100509207Medicaid