Healthcare Provider Details
I. General information
NPI: 1811570237
Provider Name (Legal Business Name): HISIS
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/03/2021
Last Update Date: 09/06/2024
Certification Date: 09/06/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
765 AMANA ST STE 400
HONOLULU HI
96814-3250
US
IV. Provider business mailing address
1481 S KING ST STE 422
HONOLULU HI
96814-2600
US
V. Phone/Fax
- Phone: 808-381-8569
- Fax:
- Phone: 808-381-8569
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 174400000X |
| Taxonomy | Specialist |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
PATRICK
ROBERT
BATTANI
Title or Position: OWNER
Credential: MPH
Phone: 808-381-8569