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Individual

DR. TRACIE F HATA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
590 FARRINGTON HWY, UNIT 526A, KAPOLEI, HI 96707-2009
(808) 674-2930
Mailing address
2101 EAST JEFFERSON STREET, ATTN THERESA BROOKS PPQA MEDICARE COMPLIANCE UNIT 6 W, ROCKVILLE, MD 20852-4908
(301) 816-6660
(301) 816-6308

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
0101238475
VA
207Q00000X
Family Medicine Physician
Primary
16197
HI
207Q00000X
Family Medicine Physician
38167
CO

Other

Enumeration date
12/05/2006
Last updated
10/31/2012
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