Provider Demographics
NPI:1386884625
Name:DANIEL M HARADA, M.D., LLC.
Entity type:Organization
Organization Name:DANIEL M HARADA, M.D., LLC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LLC OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:DANIEL
Authorized Official - Middle Name:M
Authorized Official - Last Name:HARADA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-488-4412
Mailing Address - Street 1:98-1079 MOANALUA RD
Mailing Address - Street 2:SUITE 680
Mailing Address - City:AIEA
Mailing Address - State:HI
Mailing Address - Zip Code:96701-4713
Mailing Address - Country:US
Mailing Address - Phone:808-487-7700
Mailing Address - Fax:808-488-4157
Practice Address - Street 1:98-1247 KAAHUMANU ST STE 307
Practice Address - Street 2:
Practice Address - City:AIEA
Practice Address - State:HI
Practice Address - Zip Code:96701-5301
Practice Address - Country:US
Practice Address - Phone:808-488-4412
Practice Address - Fax:808-488-4416
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-26
Last Update Date:2020-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI02208702Medicaid
HI02208702Medicaid