NPI 1104889583

Jivin Gerard Tantisira, MD

Practitioner Ophthalmology Physician Wailuku, HI

Practice location

Address: 450 Hookahi St, Wailuku, HI 96793-1447
Phone: (808) 877-3984
Fax: (808) 871-6498
Mailing address: 450 Hookahi St, Wailuku, HI 96793-1474

Registered specialties

Ophthalmology Physician Primary

Allopathic & Osteopathic Physicians Taxonomy 207W00000X Licence MD 9427 (HI)

Other Ophthalmology providers in Hawaii →

Registry record

NPI: 1104889583
Entity type: Individual
Sex (as registered): Male
NPI issued: 7 Apr 2006
Record last updated: 30 Aug 2023

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.