Healthcare Provider Details

I. General information

NPI: 1851296834
Provider Name (Legal Business Name): BLUE PACIFIC HEALTH INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/10/2026
Last Update Date: 10/10/2026
Certification Date: 10/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

91-896 MAKULE RD STE 102
EWA BEACH HI
96706-2543
US

IV. Provider business mailing address

737 BISHOP ST STE 2520
HONOLULU HI
96813-3214
US

V. Phone/Fax

Practice location:
  • Phone: 808-689-4414
  • Fax: 808-689-7115
Mailing address:
  • Phone: 808-689-4414
  • Fax: 808-689-7115

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number StateNULL

VIII. Authorized Official

Name: MARICEL SANTOS
Title or Position: VICE PRESIDENT
Credential:
Phone: 808-689-4414