Healthcare Provider Details

I. General information

NPI: 1144673252
Provider Name (Legal Business Name): HEALTHCARE PARTNERS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/14/2016
Last Update Date: 08/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

98-1005 MOANALUA RD SPC 410
AIEA HI
96701-4702
US

IV. Provider business mailing address

98-1005 MOANALUA RD SPC 410
AIEA HI
96701-4702
US

V. Phone/Fax

Practice location:
  • Phone: 808-488-5555
  • Fax: 808-441-5351
Mailing address:
  • Phone: 808-488-5555
  • Fax: 808-441-5351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2081S0010X
TaxonomySports Medicine (Physical Medicine & Rehabilitation) Physician
License Number
License Number State

VIII. Authorized Official

Name: STEPHEN T WELLS
Title or Position: PRESIDENT
Credential:
Phone: 808-445-1604