Healthcare Provider Details

I. General information

NPI: 1083773543
Provider Name (Legal Business Name): PAUL UNKRUR PHD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1150 S KING ST STE 908
HONOLULU HI
96814-1953
US

IV. Provider business mailing address

1150 S KING ST STE 908
HONOLULU HI
96814-1953
US

V. Phone/Fax

Practice location:
  • Phone: 808-597-1999
  • Fax: 808-597-1201
Mailing address:
  • Phone: 808-597-1999
  • Fax: 808-597-1201

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License NumberPSY 633
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: