Healthcare Provider Details

I. General information

NPI: 1386871036
Provider Name (Legal Business Name): MR. NEILSON HUL
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/19/2009
Last Update Date: 06/19/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 ALAKEA STREET UNIT 9
HONOLULU HI
96813
US

IV. Provider business mailing address

92-767 MAKAKILO DR #68
KAPOLEI HI
96707
US

V. Phone/Fax

Practice location:
  • Phone: 808-523-7771
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: