Healthcare Provider Details

I. General information

NPI: 1154350148
Provider Name (Legal Business Name): HAWAII EAR NOSE AND THROAT CONSULTANTS CORP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/02/2006
Last Update Date: 08/15/2023
Certification Date: 08/15/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1441 KAPIOLANI BLVD STE 1300
HONOLULU HI
96814-4489
US

IV. Provider business mailing address

725 KAPIOLANI BLVD 2301
HONOLULU HI
96813-6012
US

V. Phone/Fax

Practice location:
  • Phone: 808-951-4900
  • Fax: 808-951-4908
Mailing address:
  • Phone: 808-351-7345
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Y00000X
TaxonomyOtolaryngology Physician
License Number12358
License Number StateHI

VIII. Authorized Official

Name: SEUNG J LEE
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-351-7345