Provider Demographics
NPI:1841618048
Name:KENNETH M. SUNAMOTO, M.D., INC
Entity Type:Organization
Organization Name:KENNETH M. SUNAMOTO, M.D., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KENNETH
Authorized Official - Middle Name:MITSUO
Authorized Official - Last Name:SUNAMOTO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-524-5225
Mailing Address - Street 1:321 N KUAKINI ST STE 813
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2362
Mailing Address - Country:US
Mailing Address - Phone:808-524-5225
Mailing Address - Fax:808-524-5227
Practice Address - Street 1:321 N KUAKINI ST STE 813
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2362
Practice Address - Country:US
Practice Address - Phone:808-524-5225
Practice Address - Fax:808-524-5227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-03
Last Update Date:2014-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI2505261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI03437401Medicaid
HI03799-4OtherHMSA
HI03437401Medicaid
HIH0000BDGHQMedicare PIN