IndividualActive
Jivin Tantisira, M.D.
NPI 1104889583 · Ophthalmology Physician · Wailuku, HI
Provider details
- NPI number
- 1104889583
- Entity type
- Individual
- Primary specialty
- Ophthalmology PhysicianAllopathic & Osteopathic Physicians
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- No
- License
- MD 9427 (HI)
Practice location
450 Hookahi St
Wailuku, HI 96793-1447
Phone: (808) 877-3984
Fax: (808) 871-6498
Mailing address
450 Hookahi St
Wailuku, HI 96793-1474
Registry dates
- Enumerated
- 2006-04-07
- Last updated
- 2023-08-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.