Healthcare Provider Details

I. General information

NPI: 1205176492
Provider Name (Legal Business Name): ALOHA ALLERGY AND IMMUNOLOGY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/25/2013
Last Update Date: 06/28/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA STREET SUITE 603
HONOLULU HI
96813-2431
US

IV. Provider business mailing address

1329 LUSITANA STREET SUITE 603
HONOLULU HI
96813-2431
US

V. Phone/Fax

Practice location:
  • Phone: 808-521-9412
  • Fax:
Mailing address:
  • Phone: 808-521-9412
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD-1422
License Number StateHI
# 2
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License NumberMD-15662
License Number StateHI

VIII. Authorized Official

Name: CARL LEHMAN
Title or Position: OWNER
Credential: MD
Phone: 808-521-9412