Tantisira, Jivin Gerard
Tantisira, Jivin Gerard is an individual health care provider with primary practice located at 450 Hookahi St , Wailuku HI 96793-1447. He recently has only one registered license in Allopathic & Osteopathic Physicians / Ophthalmology, which is considered as his primary health care specialty. Tantisira, Jivin Gerard can be contacted via phone (808) 877-3984.Contact Information
Primary practice address
450 Hookahi St
Wailuku HI 96793-1447
Phone: (808) 877-3984
Fax: (808) 871-6498
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Ophthalmology | 207W00000X | MD 9427 | Hawaii |
Profile Details
| NPI number | 1104889583 |
|---|---|
| LBN Legal business name | Tantisira, Jivin Gerard |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 7th, 2006 |
| Last updated | Aug 30th, 2023 - about 3 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1104889583 | NPPES |
| Hawaii | Other | 1447298344 | ALOHA EYE CLINIC, LTD. NPI ID |
| Hawaii | Other | 20992-4 | ALOHA EYE CLINIC, LTD. NPI ID |
| Hawaii | MEDICAID | 00264901 | ALOHA EYE CLINIC, LTD. NPI ID |
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