Provider Demographics
NPI:1992520720
Name:CARL TADAKI MD CORPORATION
Entity type:Organization
Organization Name:CARL TADAKI MD CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MD OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JOEY
Authorized Official - Middle Name:
Authorized Official - Last Name:TADAKI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:808-600-4689
Mailing Address - Street 1:2033 NUUANU AVE APT 18A
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-2530
Mailing Address - Country:US
Mailing Address - Phone:808-600-4689
Mailing Address - Fax:
Practice Address - Street 1:321 N KUAKINI ST STE 714
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-2362
Practice Address - Country:US
Practice Address - Phone:808-528-3606
Practice Address - Fax:808-538-7850
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-18
Last Update Date:2024-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Multi-Specialty