Provider Demographics
NPI:1154765261
Name:CRAIG Y. HAMASAKI, M.D., LLC
Entity type:Organization
Organization Name:CRAIG Y. HAMASAKI, M.D., LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SOLE MEMBER
Authorized Official - Prefix:DR
Authorized Official - First Name:CRAIG
Authorized Official - Middle Name:Y
Authorized Official - Last Name:HAMASAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-486-9119
Mailing Address - Street 1:98-1247 KAAHUMANU ST
Mailing Address - Street 2:SUITE 224
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-5311
Mailing Address - Country:US
Mailing Address - Phone:808-486-9119
Mailing Address - Fax:808-486-9401
Practice Address - Street 1:98-1247 KAAHUMANU ST
Practice Address - Street 2:SUITE 224
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5311
Practice Address - Country:US
Practice Address - Phone:808-486-9119
Practice Address - Fax:808-486-9401
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-19
Last Update Date:2013-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD5730261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
C98449Medicare UPIN
54358Medicare PIN