Provider Demographics
NPI:1013060698
Name:INAMINE, GARY S (MD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:S
Last Name:INAMINE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1660 S KING ST
Mailing Address - Street 2:101
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96826-2066
Mailing Address - Country:US
Mailing Address - Phone:808-942-5565
Mailing Address - Fax:
Practice Address - Street 1:1660 S KING ST
Practice Address - Street 2:101
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-2066
Practice Address - Country:US
Practice Address - Phone:808-942-5565
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI3797207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HIHI00425Medicare ID - Type Unspecified
HIC98793Medicare UPIN