Healthcare Provider Details
I. General information
NPI: 1962917823
Provider Name (Legal Business Name): PUKAHI CONSULTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 12/13/2017
Last Update Date: 12/13/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3801 ANUHEA ST
HONOLULU HI
96816-3803
US
IV. Provider business mailing address
3801 ANUHEA ST
HONOLULU HI
96816-3803
US
V. Phone/Fax
- Phone: 808-255-4667
- Fax:
- Phone: 808-255-4667
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 171100000X |
| Taxonomy | Acupuncturist |
| License Number | 1171 |
| License Number State | HI |
VIII. Authorized Official
Name: MR.
HIRAM
KAHANA
PUKAHI
Title or Position: OWNER/ACUPUNCTURIST
Credential: MAOM, L.AC.
Phone: 808-255-4667