Basic Information
| Provider Information | |||||||||
| NPI: | 1356502553 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | TAMURA | ||||||||
| FirstName: | KRISTEN | ||||||||
| MiddleName: | P | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 85 MAUI LANI PKWY | ||||||||
| Address2: | |||||||||
| City: | WAILUKU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 967932416 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084425700 | ||||||||
| FaxNumber: | 8558272321 | ||||||||
| Practice Location | |||||||||
| Address1: | 175 N JACKSON AVE STE 103 | ||||||||
| Address2: | |||||||||
| City: | SAN JOSE | ||||||||
| State: | CA | ||||||||
| PostalCode: | 951161909 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4082721600 | ||||||||
| FaxNumber: | 4086040173 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/19/2008 | ||||||||
| LastUpdateDate: | 05/04/2021 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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| NPICertificationDate: | 05/04/2021 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | A114723 | CA | N | Allopathic & Osteopathic Physicians | Internal Medicine | 207RN0300X | MD19906 | HI | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Nephrology |
No ID Information.