Healthcare Provider Details

I. General information

NPI: 1386965762
Provider Name (Legal Business Name): ANESTHESIA INNOVATIONS LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/19/2010
Last Update Date: 09/08/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1712 LILIHA ST SUITE 301
HONOLULU HI
96817-5410
US

IV. Provider business mailing address

7192 KALANIANAOLE HWY SUITE A143A/144
HONOLULU HI
96825-1800
US

V. Phone/Fax

Practice location:
  • Phone: 808-206-5301
  • Fax: 808-447-8696
Mailing address:
  • Phone: 808-206-5301
  • Fax: 808-447-8696

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMD-15642
License Number StateHI

VIII. Authorized Official

Name: DR. JERALD MARK GARCIA
Title or Position: SOLE PROPRIETOR
Credential: M.D.
Phone: 612-226-0242