Provider Demographics
NPI:1104916196
Name:ANNE A TANABE MD INC
Entity type:Organization
Organization Name:ANNE A TANABE MD INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT, ANNE A TANABE MD INC.
Authorized Official - Prefix:DR
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:A
Authorized Official - Last Name:TANABE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-536-7556
Mailing Address - Street 1:321 N KUAKINI ST STE 402
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2386
Mailing Address - Country:US
Mailing Address - Phone:808-536-7546
Mailing Address - Fax:808-536-7553
Practice Address - Street 1:321 N KUAKINI ST STE 402
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2386
Practice Address - Country:US
Practice Address - Phone:808-536-7546
Practice Address - Fax:808-536-7553
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-13
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11057207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI1124047634OtherNPI FOR INDIVIDUAL
HI56703OtherGROUP PIN
HI50182602Medicaid
HI56705OtherPIN
HI00A0229169OtherHMSA
HI1124047634OtherNPI FOR INDIVIDUAL
HI00A0229169Medicare ID - Type Unspecified