Provider Demographics
NPI:1689681439
Name:ANDO, RICHARD ETSUO JR (MD)
Entity type:Individual
Prefix:DR
First Name:RICHARD
Middle Name:ETSUO
Last Name:ANDO
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:405 N KUAKINI ST
Mailing Address - Street 2:SUITE 903
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96817-6300
Mailing Address - Country:US
Mailing Address - Phone:808-538-1915
Mailing Address - Fax:
Practice Address - Street 1:405 N KUAKINI ST
Practice Address - Street 2:SUITE 903
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96817-6300
Practice Address - Country:US
Practice Address - Phone:808-538-1915
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-02
Last Update Date:2025-09-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIMD6238207K00000X, 208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
No208000000XAllopathic & Osteopathic PhysiciansPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
HI00A003518OtherHMSA ETAL
HI031734Medicaid
E68990Medicare UPIN
HI0000BDPLVMedicare ID - Type Unspecified