Healthcare Provider Details

I. General information

NPI: 1700644424
Provider Name (Legal Business Name): SURGICALLIANCE LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/07/2024
Last Update Date: 01/27/2025
Certification Date: 01/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BERETANIA ST STE 890
HONOLULU HI
96814-1871
US

IV. Provider business mailing address

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

V. Phone/Fax

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

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JERALD GARCIA
Title or Position: PRESIDENT
Credential: MD
Phone: 808-206-5301