Organization
BRADLEY KOIZUMI MD INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. BRADLEY KOIZUMI M.D. (PRESIDENT)
(808) 488-6833
Entity
Organization
Contact information
Practice address
99-128 AIEA HEIGHTS DR, SUITE 106, AIEA, HI 96701-3925
(808) 488-6833
(808) 591-8880
Mailing address
99-128 AIEA HEIGHTS DR, SUITE 106, AIEA, HI 96701-3925
(808) 488-6833
(808) 591-8880
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
03321
HI
207RC0000X
Cardiovascular Disease Physician
03321
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04029201
—
HI
Enumeration date
01/30/2013
Last updated
01/30/2013
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