Provider Demographics
NPI:1871798132
Name:KANESHIGE, JASON RIKI (MD)
Entity type:Individual
Prefix:
First Name:JASON
Middle Name:RIKI
Last Name:KANESHIGE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:550 S BERETANIA ST STE 503
Mailing Address - Street 2:
Mailing Address - City:HONOLULU
Mailing Address - State:HI
Mailing Address - Zip Code:96813-2496
Mailing Address - Country:US
Mailing Address - Phone:808-548-7033
Mailing Address - Fax:808-548-7034
Practice Address - Street 1:550 S BERETANIA ST STE 503
Practice Address - Street 2:
Practice Address - City:HONOLULU
Practice Address - State:HI
Practice Address - Zip Code:96813-2496
Practice Address - Country:US
Practice Address - Phone:808-548-7033
Practice Address - Fax:808-548-7034
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-18
Last Update Date:2011-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HI16009207XX0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207XX0801XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryOrthopaedic Trauma