Provider Demographics
NPI:1982662987
Name:UCHIMA, TODD MITSUO (PA-C)
Entity Type:Individual
Prefix:MR
First Name:TODD
Middle Name:MITSUO
Last Name:UCHIMA
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:755 SCOTT CIR
Mailing Address - Street 2:
Mailing Address - City:JBPHH
Mailing Address - State:HI
Mailing Address - Zip Code:96853-5399
Mailing Address - Country:US
Mailing Address - Phone:808-448-6100
Mailing Address - Fax:808-448-6113
Practice Address - Street 1:755 SCOTT CIR
Practice Address - Street 2:
Practice Address - City:JBPHH
Practice Address - State:HI
Practice Address - Zip Code:96853-5399
Practice Address - Country:US
Practice Address - Phone:808-448-6100
Practice Address - Fax:808-448-6113
Is Sole Proprietor?:No
Enumeration Date:2006-05-02
Last Update Date:2023-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIAMD226363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000251397OtherHMSA
HI576689Medicaid
HI8378241OtherUHA
HI100874Medicare ID - Type Unspecified
HI0000251397OtherHMSA