Most Relevant Information
Provider Data
| NPI Number: | 1003037052 |
| Provider Name: | HOMAYON M. TAVAKOLI M.D. |
| Entity Type: | Individual |
| Taxonomy Code: | 208D00000X |
| Specialty: | General Practice |
| License Number: | MD-7153 |
Most Important Dates
| Enumeration Date: | 05/01/2007 |
| Last Updated: | 07/08/2007 |
Provider Practice Location
1325 S. KIHEI RD.
SUITE # 103
KIHEI
HI
96753
Practice Location Phone/Fax
| Phone: | 8088797781 |
| Fax: | 8088790594 |
Provider Mailing Location
1325 S. KIHEI RD.
SUITE # 103
KIHEI
HI
96753
Provider Mailing Phone/Fax
| Phone: | 8088797781 |
| Fax: | 8088790594 |