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Individual

KEN NAGAMORI

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
1319 PUNAHOU ST, SUITE 1030, HONOLULU, HI 96826-1077
(808) 955-7772
(808) 955-0789
Mailing address
1319 PUNAHOU ST, SUITE 1030, HONOLULU, HI 96826-1001
(808) 955-7772
(808) 955-0789

Taxonomy

Speciality
Code
Description
License number
State
2080A0000X
Pediatric Adolescent Medicine Physician
Primary
5279
HI
2080P0206X
Pediatric Gastroenterology Physician
5279
HI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
00188310
ALOHA CARE
HI
05
01883101
HI
01
A20220
HMSA
HI
01
MD5279
MDX
HI
Enumeration date
10/24/2006
Last updated
01/27/2011
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