Healthcare Provider Details

I. General information

NPI: 1518993831
Provider Name (Legal Business Name): HAWAII NEUROSURGERY GROUP LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/26/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1380 LUSITANA ST #1012
HONOLULU HI
96813-2421
US

IV. Provider business mailing address

1380 LUSITANA ST #1012
HONOLULU HI
96813-2421
US

V. Phone/Fax

Practice location:
  • Phone: 808-546-5000
  • Fax: 808-523-1992
Mailing address:
  • Phone: 808-546-5000
  • Fax: 808-523-1992

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207T00000X
TaxonomyNeurological Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: LEON KHIKLIONG LIEM
Title or Position: PARTNER
Credential: MD
Phone: 808-546-5000