MEDICARE: EMI KOGA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041S0200X	School Social Worker

General Provider Information

NPI Number	:	1043462138
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	EMI KOGA

Provider Business Mailing Address
First Line	:	200 N VINEYARD BLVD FL 2
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-3950
Country	:	US
Telephone Number	:	808-535-0132
Fax Number	:	808-599-8761

Provider Business Practice Location Address
First Line	:	200 N VINEYARD BLVD FL 2
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96817-3950
Country	:	US
Telephone Number	:	808-535-0132
Fax Number	:	808-599-8761

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2008
Last Update Date	:	10/21/2008

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Directions to “ EMI KOGA ” Practice Location

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