Provider Demographics
NPI:1831313113
Name:ROY H. TANAKA, D.C., INC.
Entity Type:Organization
Organization Name:ROY H. TANAKA, D.C., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:H
Authorized Official - Last Name:TANAKA
Authorized Official - Suffix:
Authorized Official - Credentials:DC
Authorized Official - Phone:808-596-0220
Mailing Address - Street 1:1221 KAPIOLANI BLVD
Mailing Address - Street 2:SUITE 1046
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-3503
Mailing Address - Country:US
Mailing Address - Phone:808-596-0220
Mailing Address - Fax:808-596-0221
Practice Address - Street 1:1221 KAPIOLANI BLVD
Practice Address - Street 2:SUITE 1046
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96814-3503
Practice Address - Country:US
Practice Address - Phone:808-596-0220
Practice Address - Fax:808-596-0221
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI99111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes111N00000XChiropractic ProvidersChiropractorGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000QCBRTMedicare ID - Type Unspecified
HIT41289Medicare UPIN