Provider Demographics
NPI:1699900118
Name:JAMES M WARNER MD LLC
Entity type:Organization
Organization Name:JAMES M WARNER MD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEMBER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:M
Authorized Official - Last Name:WARNER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-597-1379
Mailing Address - Street 1:1288 KAPIOLANI BLVD
Mailing Address - Street 2:APT 4605
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96814-2888
Mailing Address - Country:US
Mailing Address - Phone:808-597-1379
Mailing Address - Fax:
Practice Address - Street 1:820 MILILANI ST
Practice Address - Street 2:SUITE 702A
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2993
Practice Address - Country:US
Practice Address - Phone:808-523-9363
Practice Address - Fax:808-523-9418
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-05-28
Last Update Date:2009-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD11902207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A0254092OtherOTHER
HI57020101Medicaid