Provider Demographics
NPI:1942290150
Name:HASSELL, LOMA HARRISON II (MD)
Entity Type:Individual
Prefix:DR
First Name:LOMA
Middle Name:HARRISON
Last Name:HASSELL
Suffix:II
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:PO BOX 811
Mailing Address - Street 2:
Mailing Address - City:KIHEI
Mailing Address - State:HI
Mailing Address - Zip Code:96753-0811
Mailing Address - Country:US
Mailing Address - Phone:808-280-9638
Mailing Address - Fax:844-342-7003
Practice Address - Street 1:567 KUPULAU DR
Practice Address - Street 2:
Practice Address - City:KIHEI
Practice Address - State:HI
Practice Address - Zip Code:96753-6316
Practice Address - Country:US
Practice Address - Phone:808-280-9638
Practice Address - Fax:844-342-7003
Is Sole Proprietor?:No
Enumeration Date:2005-10-27
Last Update Date:2021-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-6144207RN0300X
TXM5215207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrology