Provider Demographics
NPI:1134222151
Name:MUTO, JAMES E (MD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:E
Last Name:MUTO
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 1:89 HOOKELE STREET
Mailing Address - Street 2:#103
Mailing Address - City:KAHULUI
Mailing Address - State:HI
Mailing Address - Zip Code:96732
Mailing Address - Country:US
Mailing Address - Phone:808-871-8878
Mailing Address - Fax:808-871-8867
Practice Address - Street 1:89 HOOKELE ST
Practice Address - Street 2:#103
Practice Address - City:KAHULUI
Practice Address - State:HI
Practice Address - Zip Code:96732-3532
Practice Address - Country:US
Practice Address - Phone:808-871-8878
Practice Address - Fax:808-871-8867
Is Sole Proprietor?:No
Enumeration Date:2006-09-06
Last Update Date:2011-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD9083207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI07674601Medicaid
204453OtherHMSA
HI07674601Medicaid
204453OtherHMSA