Healthcare Provider Details

I. General information

NPI: 1710284740
Provider Name (Legal Business Name): ABERCO MEDICAL ACCESS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/28/2011
Last Update Date: 02/28/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2100 KANOELEHUA AVE STE B9
HILO HI
96720-5269
US

IV. Provider business mailing address

2100 KANOELEHUA AVE STE B9
HILO HI
96720-5269
US

V. Phone/Fax

Practice location:
  • Phone: 808-981-1700
  • Fax:
Mailing address:
  • Phone: 808-981-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License NumberMD9667
License Number StateHI

VIII. Authorized Official

Name: VAL ABERIN
Title or Position: OFFICE MANAGER
Credential:
Phone: 808-981-1700