Bradley Koizumi MD Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

03321 Issued in HI

Legal business name

BRADLEY KOIZUMI MD INC

Practice address

99-128 Aiea Heights Dr
Suite 106
Aiea, HI 96701-3925

Phone

(808) 488-6833

Fax

(808) 591-8880

NPI assigned

Jan 30, 2013

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Bradley Koizumi, M.D.

Title

President

Phone

(808) 488-6833

Specialties & licenses 2

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1359504000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1359504000000",
    "number": "1306184148",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DR",
            "address_2": "SUITE 106",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013925",
            "telephone_number": "808-488-6833",
            "fax_number": "808-591-8880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "99-128 AIEA HEIGHTS DR",
            "address_2": "SUITE 106",
            "city": "AIEA",
            "state": "HI",
            "postal_code": "967013925",
            "telephone_number": "808-488-6833",
            "fax_number": "808-591-8880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRADLEY KOIZUMI MD INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-01-30",
        "last_updated": "2013-01-30",
        "status": "A",
        "authorized_official_last_name": "KOIZUMI",
        "authorized_official_first_name": "BRADLEY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "808-488-6833",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "03321",
            "primary": true
        },
        {
            "code": "207RC0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine, Cardiovascular Disease",
            "state": "HI",
            "license": "03321",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "04029201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Rebecca Boutin
• Aidan Bowie
• Rebecca Sue Bowman, RN
• Kellie Brack
• Margarita Bradford
• Lauren Elise Shumaker Bradley
• Brandon D. Young, MD, LLC
• Brandon J McNichols PSYD, LLC
• Zachary Branning, DC
• Havalyn Bremer

• Internal Medicine Physician in Aiea, HI
• Providers in Aiea, HI by specialty
• Internal Medicine Physician in Hawaii

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.