Provider Demographics
NPI:1699876771
Name:MORITA, NAOMI F (MD)
Entity type:Individual
Prefix:DR
First Name:NAOMI
Middle Name:F
Last Name:MORITA
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 1:94-1480 MOANIANI ST
Mailing Address - Street 2:
Mailing Address - City:WAIPAHU
Mailing Address - State:HI
Mailing Address - Zip Code:96797-4632
Mailing Address - Country:US
Mailing Address - Phone:808-432-3100
Mailing Address - Fax:
Practice Address - Street 1:94-1480 MOANIANI ST
Practice Address - Street 2:
Practice Address - City:WAIPAHU
Practice Address - State:HI
Practice Address - Zip Code:96797-4632
Practice Address - Country:US
Practice Address - Phone:808-432-3100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-25
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD-8190207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI0000038539OtherHMSA BILLING NUMBER
HI034880-02Medicaid
HIH0000BDVGGMedicare PIN
HIE83288Medicare UPIN