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NPI #1689056350 in Haleiwa, Hawaii

Provider Information

NPI Number: 1689056350
Entity Type: Organization
Organization Name: None
Primary Specialty: Student in an Organized Health Care Education/Training Program
Enumeration Date: Jun 18, 2015
Last Updated: Jun 18, 2015

Practice Location

Address: 58-290 KAMEHAMEHA HWY
City: Haleiwa
State: Hawaii
ZIP Code: 96712-9716
Phone: (808) 223-0936

Authorized Official

Name: MS. TIANA ROSE L AHUE
Title: STUDENT
Phone: (808) 223-0936

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Student in an Organized Health Care Education/Training Program	390200000X	Primary

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