Clifford Teruo Tanaka, M.D.

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

5220 Issued in HI

Practice address

46-001 Kamehameha Highway
Suite 312
Kaneohe, HI 96744

Phone

(808) 247-2255

Fax

(808) 247-7642

NPI assigned

Oct 4, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1159920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1700972452",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "46-001 KAMEHAMEHA HIGHWAY",
            "address_2": "SUITE 312",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "808-247-2255",
            "fax_number": "808-247-7642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "46-001 KAMEHAMEHA HIGHWAY",
            "address_2": "SUITE 312",
            "city": "KANEOHE",
            "state": "HI",
            "postal_code": "96744",
            "telephone_number": "808-247-2255",
            "fax_number": "808-247-7642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANAKA",
        "first_name": "CLIFFORD",
        "middle_name": "TERUO",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-04",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "HI",
            "license": "5220",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS/SHIELD",
            "identifier": "00A0021335",
            "state": "HI"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "01939201",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Dylan Kenta Takara, OTD
• Ronalyn Miranda Nuesca Takata
• Jerald Satoru Takesono, D.D.S.
• Tod-Casey Takeuchi
• Kelli Takushi-Geyrozaga, MS CCC-SLP
• Alan Minoru Taniguchi, M.D.
• Tara Lynn Tannenholz, RPT
• Halona Wes Tanner, PSY.D.
• Laie Tapusoa
• Shelley Tasaka, O.D.

• Internal Medicine Physician in Kaneohe, HI
• Providers in Kaneohe, 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 Jul 8, 2007; 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.