Provider Demographics
NPI:1245362235
Name:SHINTANI, TERRY (MD, MPH)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:
Last Name:SHINTANI
Suffix:
Gender:M
Credentials:MD, MPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:222 VINEYARD ST STE 601
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2455
Mailing Address - Country:US
Mailing Address - Phone:808-521-3097
Mailing Address - Fax:
Practice Address - Street 1:2525 S KING ST
Practice Address - Street 2:SUITE 309
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96826-3101
Practice Address - Country:US
Practice Address - Phone:808-521-3097
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-12
Last Update Date:2007-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI56242083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI9290719OtherUNIVERSITY HEALTH ALLIANC
HIMD5624-01OtherQUEENS HEALTH PLAN
HIA2698-7OtherHMSA
HIMD5624-01OtherQUEENS HEALTH PLAN
HIA2698-7OtherHMSA