Basic Information
| Provider Information | |||||||||
| NPI: | 1922242809 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | TADAKI | ||||||||
| FirstName: | CARL | ||||||||
| MiddleName: | JOSEPH | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 677 ALA MOANA BLVD | ||||||||
| Address2: | 1001 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968135419 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8084694929 | ||||||||
| FaxNumber: | 8085879507 | ||||||||
| Practice Location | |||||||||
| Address1: | 405 N KUAKINI ST | ||||||||
| Address2: | SUITE 601 | ||||||||
| City: | HONOLULU | ||||||||
| State: | HI | ||||||||
| PostalCode: | 968176300 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8085365811 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 04/23/2009 | ||||||||
| LastUpdateDate: | 08/10/2016 | ||||||||
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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 | 208600000X | MD432824 | PA | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | 44300 | KY | N | Allopathic & Osteopathic Physicians | Surgery | 208600000X | MD18563 | HI | Y | Allopathic & Osteopathic Physicians | Surgery |
No ID Information.