Healthcare Provider Details

I. General information

NPI: 1871812578
Provider Name (Legal Business Name): BEN I. HUR M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/20/2010
Last Update Date: 05/21/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD
HONOLULU HI
96814-4402
US

IV. Provider business mailing address

2594 KINGFISHER LN
LINCOLN CA
95648-8753
US

V. Phone/Fax

Practice location:
  • Phone: 808-946-1414
  • Fax:
Mailing address:
  • Phone: 916-253-3694
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD-2358
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: