Individual
DR. JIVIN GERARD TANTISIRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 HOOKAHI ST, WAILUKU, HI 96793-1447
(808) 877-3984
(808) 871-6498
Mailing address
450 HOOKAHI ST, WAILUKU, HI 96793-1474
(808) 877-3984
(808) 871-6498
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD 9427
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00264901
—
HI
01
—
1447298344
ALOHA EYE CLINIC, LTD. NPI ID
HI
01
—
20992-4
HMSA
HI
Enumeration date
04/07/2006
Last updated
08/30/2023
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