# SUSAN MIKAMI MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1760612329
- **Authorized official:** DR. SUSAN MIKAMI M.D. (AGENT)
- **Authorized official phone:** (808) 351-1012

## Contact information

- **Practice address:** 1100 WARD AVE, SUITE 810, HONOLULU, HI 96814-1600
- **Practice address phone:** (808) 351-1012
- **Mailing address:** PO BOX 10012, HONOLULU, HI 96816-0012
- **Mailing address phone:** (808) 351-1012

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208000000X | Pediatrics Physician | 13933 | HI | — |
| 2084P0800X | Psychiatry Physician | 13933 | HI | — |
| 2084P0804X | Child & Adolescent Psychiatry Physician | 13933 | HI | Yes |

## Other

- **Enumeration date:** 07/16/2009
- **Last updated:** 07/28/2009