Basic Information
| Provider Information | |||||||||
| NPI: | 1265705594 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ANDREW MAEDA MD LLC | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1329 LUSITANA ST | ||||||||
| Address2: | STE 604 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085311116 | ||||||||
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| Practice Location | |||||||||
| Address1: | 1329 LUSITANA ST | ||||||||
| Address2: | STE 604 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968132429 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085311116 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 02/16/2012 | ||||||||
| LastUpdateDate: | 10/29/2013 | ||||||||
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| AuthorizedOfficialLastName: | MAEDA | ||||||||
| AuthorizedOfficialFirstName: | ANDREW | ||||||||
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| AuthorizedOfficialTitleorPosition: | MEMBER | ||||||||
| AuthorizedOfficialTelephone: | 8083668875 | ||||||||
| IsSoleProprietor: | |||||||||
| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | DR. | ||||||||
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| AuthorizedOfficialCredential: | M.D. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | MD-16487 | HI | Y | Hospitals | General Acute Care Hospital |
No ID Information.