Provider Demographics
NPI:1316055726
Name:FUJITA, JAN TOYOKO (MD)
Entity type:Individual
Prefix:
First Name:JAN
Middle Name:TOYOKO
Last Name:FUJITA
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:99-128 AIEA HEIGHTS DR STE 403
Mailing Address - Street 2:
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-3934
Mailing Address - Country:US
Mailing Address - Phone:808-487-8880
Mailing Address - Fax:808-487-8283
Practice Address - Street 1:99-128 AIEA HEIGHTS DR STE 403
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-3934
Practice Address - Country:US
Practice Address - Phone:808-487-8880
Practice Address - Fax:808-487-8283
Is Sole Proprietor?:No
Enumeration Date:2006-08-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI7941207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI075074 01Medicaid
HIG03576Medicare UPIN
HI075074 01Medicaid