Provider Demographics
NPI:1942325675
Name:ALLERGY ASTHMA SPECIALTIES INC
Entity Type:Organization
Organization Name:ALLERGY ASTHMA SPECIALTIES INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:ETSUO
Authorized Official - Last Name:ANDO
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:808-538-1915
Mailing Address - Street 1:405 N KUAKINI ST
Mailing Address - Street 2:#903 KHAKINI PHYSICIANS TOWER
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6302
Mailing Address - Country:US
Mailing Address - Phone:808-538-1915
Mailing Address - Fax:808-573-0791
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:#903 KHAKINI PHYSICIANS TOWER
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6302
Practice Address - Country:US
Practice Address - Phone:808-538-1915
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD 6238207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered207K00000XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyGroup - Multi-Specialty
Not Answered208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A003518OtherHMSA
HI031734Medicaid
E68990Medicare UPIN
HI031734Medicaid