Healthcare Provider Details

I. General information

NPI: 1346486941
Provider Name (Legal Business Name): PULMONARY CLINIC OF HAWAII INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/02/2009
Last Update Date: 06/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

846 S HOTEL ST STE 102
HONOLULU HI
96813-2583
US

IV. Provider business mailing address

820 MILILANI ST STE 702A
HONOLULU HI
96813-2993
US

V. Phone/Fax

Practice location:
  • Phone: 808-536-2031
  • Fax: 808-536-2033
Mailing address:
  • Phone: 808-523-9363
  • Fax: 808-523-9418

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RP1001X
TaxonomyPulmonary Disease Physician
License NumberMD 1806
License Number StateHI

VIII. Authorized Official

Name: ROY S ADANIYA
Title or Position: OWNER
Credential: MD
Phone: 808-536-2031