Provider Demographics
NPI:1851669469
Name:JON S. FUJITA, M.D., INC.
Entity Type:Organization
Organization Name:JON S. FUJITA, M.D., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JON
Authorized Official - Middle Name:SHINICHI
Authorized Official - Last Name:FUJITA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-487-8880
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR STE 402
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3934
Mailing Address - Country:US
Mailing Address - Phone:808-487-8880
Mailing Address - Fax:808-487-8283
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 402
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3934
Practice Address - Country:US
Practice Address - Phone:808-487-8880
Practice Address - Fax:808-487-8283
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-09
Last Update Date:2011-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6060207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty