| Braxton Seiya Fukutomi, | |
|
2828 Paa St, Honolulu, HI 96819-4430 | |
| (808) 432-5777 | |
| Not Available |
| Full Name | Braxton Seiya Fukutomi |
|---|---|
| Gender | Male |
| Speciality | Internal Medicine |
| Experience | 6 Years |
| Location | 2828 Paa St, Honolulu, Hawaii |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053970350 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | MDR-7736 (Hawaii) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| University Of Utah Hospitals And Clinics | Salt lake city, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| University Of Utah Adult Services | 0941525273 | 1593 |
| Entity Name | University Of Utah Community Physicians Group |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1598169203 PECOS PAC ID: 9739403569 Enrollment ID: O20150126002118 |
| Entity Name | University Of Utah Adult Services |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1114321981 PECOS PAC ID: 0941525273 Enrollment ID: O20150209001683 |
| Mailing Address | Practice Location Address |
|---|---|
| Braxton Seiya Fukutomi, 2828 Paa St, Honolulu, HI 96819-4430 Ph: () - | Braxton Seiya Fukutomi, 2828 Paa St, Honolulu, HI 96819-4430 Ph: (808) 432-5777 |
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