Individual
DR. RUSSELL G TACATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1619 LILIHA STREET, #3, HONOLULU, HI 96817-3152
(808) 531-5454
(808) 531-5451
Mailing address
1619 LILIHA STREET, #3, HONOLULU, HI 96817-3152
(808) 531-5454
(808) 531-5451
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
9570
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
020779-5
HMSA
—
05
—
07892401
—
HI
Enumeration date
07/22/2005
Last updated
08/03/2023
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