Healthcare Provider Details
I. General information
NPI: 1760004550
Provider Name (Legal Business Name): SYNERGY HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/14/2020
Last Update Date: 05/14/2020
Certification Date: 05/14/2020
Deactivation Date:
Reactivation Date:
III. Provider practice location address
321 N KUAKINI ST STE 714
HONOLULU HI
96817-2362
US
IV. Provider business mailing address
217 PROSPECT ST APT F1
HONOLULU HI
96813-1760
US
V. Phone/Fax
- Phone: 808-528-3606
- Fax: 808-538-7850
- Phone: 808-741-3037
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207R00000X |
| Taxonomy | Internal Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
CHRISTIAN
KITAMURA
Title or Position: DOCTOR
Credential: MD
Phone: 808-741-3037