Provider Demographics
NPI:1851438360
Name:MIKI MEDICAL ASSOCIATES, INC
Entity Type:Organization
Organization Name:MIKI MEDICAL ASSOCIATES, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:NOBUYUKI
Authorized Official - Middle Name:
Authorized Official - Last Name:MIKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-521-5220
Mailing Address - Street 1:405 N KUAKINI ST STE 1004
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6301
Mailing Address - Country:US
Mailing Address - Phone:808-521-5220
Mailing Address - Fax:808-441-5588
Practice Address - Street 1:405 N KUAKINI ST STE 1004
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6301
Practice Address - Country:US
Practice Address - Phone:808-521-5220
Practice Address - Fax:808-441-5588
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2022-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIW20575556-01OtherHI STATE TAX ID NUMBER
HIW20575556-01OtherHI STATE TAX ID NUMBER
151517Medicare ID - Type UnspecifiedMEDICARE PROVIDER NUMBER