Individual
JON FUKUMOTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1329 LUSITANA ST STE 307, HONOLULU, HI 96813-2435
(808) 524-6115
(808) 528-1711
Mailing address
1329 LUSITANA ST STE 307, HONOLULU, HI 96813-2435
(808) 524-6115
Taxonomy
Speciality
Code
Description
License number
State
207RH0000X
Hematology (Internal Medicine) Physician
Primary
MD 13701
HI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000262758
HMSA
HI
05
—
586125-01
—
HI
Enumeration date
08/30/2006
Last updated
07/18/2019
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