Provider Demographics
NPI:1922242809
Name:TADAKI, CARL JOSEPH (MD)
Entity Type:Individual
Prefix:DR
First Name:CARL
Middle Name:JOSEPH
Last Name:TADAKI
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:677 ALA MOANA BLVD
Mailing Address - Street 2:1001
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-5419
Mailing Address - Country:US
Mailing Address - Phone:808-469-4929
Mailing Address - Fax:808-587-9507
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE 601
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-536-5811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-04-23
Last Update Date:2016-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD432824208600000X
KY44300208600000X
HIMD18563208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery