person
Dr. Russell G Tacata, MD
General Practice Physician in Honolulu, Hawaii
NPI 1356341002

Russell G Tacata is a General Practice Physician based in Honolulu, HI. Russell G Tacata practices in Honolulu, HI and has the professional credentials of MD. The NPI Number for Russell G Tacata is 1356341002 and holds a License No. 9570 (Hawaii).

The current practice location address for Russell G Tacata is 1619 Liliha Street, Honolulu, HI and can be reached out via phone at 808-531-5454 and via fax at 808-531-5451.

Location: 1619 Liliha Street, Honolulu, HI, 96817-3152
person
Provider Profile Details
NPI Number
1356341002
Provider Name
Russell G Tacata
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
1619 Liliha Street, Honolulu, HI, 96817-3152
Phone Number
808-531-5454
Fax Number
808-531-5451
Provider Enumeration Date
07/22/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
07892401 05 HI
020779-5 01 HMSA
institution
Provider Business Practice Location Address Details
Address
1619 Liliha Street
City
State
Zip
96817-3152
Phone Number
808-531-5454
Fax Number
808-531-5451
person
Provider Business Mailing Address Details
Address
1619 Liliha Street
City
State
Zip
96817-3152
Phone Number
808-531-5454
Fax Number
808-531-5451
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
General Practice
Speciality
-
Taxonomy
License No.
9570 (Hawaii)
Definition
Definition to come...
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