Healthcare Provider Details

I. General information

NPI: 1942089172
Provider Name (Legal Business Name): UNIVERSITY OF MEDICAL SCIENCES HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/26/2023
Last Update Date: 09/26/2023
Certification Date: 09/26/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1001 BISHOP ST STE 1035
HONOLULU HI
96813-3481
US

IV. Provider business mailing address

1001 BISHOP ST STE 1035
HONOLULU HI
96813-3481
US

V. Phone/Fax

Practice location:
  • Phone: 808-520-0111
  • Fax: 808-726-2620
Mailing address:
  • Phone: 808-520-0111
  • Fax: 808-726-2620

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code225400000X
TaxonomyRehabilitation Practitioner
License Number
License Number State

VIII. Authorized Official

Name: JANICE PITTS
Title or Position: CEO
Credential:
Phone: 808-520-0111