Healthcare Provider Details

I. General information

NPI: 1205417243
Provider Name (Legal Business Name): CITY AND COUNTY OF HONOLULU
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/20/2021
Last Update Date: 12/15/2022
Certification Date: 12/15/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3375 KOAPAKA ST STE F231
HONOLULU HI
96819-1865
US

IV. Provider business mailing address

3375 KOAPAKA ST STE F231
HONOLULU HI
96819-1865
US

V. Phone/Fax

Practice location:
  • Phone: 808-723-7800
  • Fax:
Mailing address:
  • Phone: 808-723-7800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code146L00000X
TaxonomyParamedic
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code146N00000X
TaxonomyBasic Emergency Medical Technician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code207PE0004X
TaxonomyEmergency Medical Services (Emergency Medicine) Physician
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State

VIII. Authorized Official

Name: IAN T T SANTEE
Title or Position: DEPUTY DIRECTOR
Credential: MICT, MPA
Phone: 808-723-7800