Provider Demographics
NPI:1831171925
Name:IZUKA, BYRON HIDEO (MD)
Entity type:Individual
Prefix:DR
First Name:BYRON
Middle Name:HIDEO
Last Name:IZUKA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:98-1247 KAAHUMANU ST STE 122
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5300
Mailing Address - Country:US
Mailing Address - Phone:808-485-8985
Mailing Address - Fax:808-485-8986
Practice Address - Street 1:98-1247 KAAHUMANU ST STE 122
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5300
Practice Address - Country:US
Practice Address - Phone:808-485-8985
Practice Address - Fax:808-485-8986
Is Sole Proprietor?:No
Enumeration Date:2005-11-15
Last Update Date:2022-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD10533207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI49997207Medicaid
HI49997208Medicaid
HI49997207Medicaid
H38950Medicare UPIN