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:
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Health care specialties

SpecialtyCodeLicense #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 last year

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.

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Identifiers

StateTypeNumberIssuer
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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