Healthcare Provider Details

I. General information

NPI: 1659142404
Provider Name (Legal Business Name): ALL ACCESS ORTHO OAHU LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2024
Last Update Date: 05/29/2024
Certification Date: 05/29/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BERETANIA ST STE 102
HONOLULU HI
96814-1871
US

IV. Provider business mailing address

55 MERCHANT ST FL 27
HONOLULU HI
96813-4333
US

V. Phone/Fax

Practice location:
  • Phone: 808-356-5699
  • Fax: 808-356-5698
Mailing address:
  • Phone: 808-535-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: ART GLADSTONE
Title or Position: PRESIDENT
Credential:
Phone: 808-535-7593