MEDICARE: MR. BRANDON FLEWELLING L. AC

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	171100000X	Acupuncturist	1051	HI
2	225700000X	Massage Therapist	18457	HI

General Provider Information

NPI Number	:	1659913937
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. BRANDON FLEWELLING L. AC

Provider Business Mailing Address
First Line	:	4747 KILAUEA AVE STE 115
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5308
Country	:	US
Telephone Number	:	808-255-7815
Fax Number	:	808-748-0326

Provider Business Practice Location Address
First Line	:	4747 KILAUEA AVE STE 115
Second Line	:
City	:	HONOLULU
State	:	HI
Zip	:	96816-5308
Country	:	US
Telephone Number	:	808-255-7815
Fax Number	:	808-748-0326

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

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	05/30/2026

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