Basic Information
| Provider Information | |||||||||
| NPI: | 1679777080 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | PALANISWAMI | ||||||||
| FirstName: | ARUN | ||||||||
| MiddleName: | NALLAGOUNDER | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1645 ALA WAI BLVD | ||||||||
| Address2: | APT#1203 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968151065 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3123030229 | ||||||||
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| Practice Location | |||||||||
| Address1: | 2226 LILIHA ST | ||||||||
| Address2: | |||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968171600 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085476011 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 06/12/2007 | ||||||||
| LastUpdateDate: | 10/08/2009 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 282N00000X | 2006016511 | MO | Y | Hospitals | General Acute Care Hospital |
ID Information
| ID | Type | State | Issuer | Description | MD15357 | 01 | HI | HAWAII MEDICAL LICENCSE | OTHER | 2006016511 | 01 | MO | LICENSCE NUMBER | OTHER |