Unknown Individual – Specialist, NPI 1053361964

Unknown Individual is a healthcare provider. based in Honolulu, Hawaii. specializing in Specialist. They hold a License No. 2193 (HI). The NPI Number for Unknown Individual is 1053361964

Main info

Organization
Inactive
55 Years Of Experience
Accepts Medicare Assignment
Name
Unknown Individual
NPI
1053361964
Phone
(808) 521-8585
Address
405 N KUAKINI ST
Deactivation Date
9 May 2022

Doctor Profile

Medical School Name
UNIVERSITY OF CALIFORNIA, GEFFEN SCHOOL OF MEDICINE
Secondary Phone
8085218585
Graduation Year
1971 (55 years ago)
PAC ID
0446359632
Professional Enrollment ID
I20070629000139
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience14
Completeness75
Years active:0State licenses:1Digital endpointsOther names

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Provider Addresses for Unknown Individual

  • 405, North Kuakini Street, Liliha, Honolulu, Honolulu County, Hawaii, 96817, United States

    SUITE 1109

    HONOLULU, HI 968176300

    Phone: (808) 521-8585

    Fax: (808) 523-3805

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 96817)

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Reviews

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Frequently asked questions

Can I use this page to confirm Unknown Individual's NPI?
Yes. Unknown Individual is listed with NPI 1053361964 in the public NPI dataset.
What dates should I check for Unknown Individual's activity?
We display what the registry publishes: Unknown Individual appears inactive there.
What is Unknown Individual's specialty?
The listing groups Unknown Individual with Other Service Providers. Clinical services aligned with this taxonomy classification.
What address line appears for Unknown Individual?
Unknown Individual's geographic hint is Honolulu, Hawaii in our summary view.
How many locations tie to this NPI?
2 practice locations appear in the available data.

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