Healthcare Provider Details

I. General information

NPI: 1114322880
Provider Name (Legal Business Name): REHAB ASSOCIATES OF THE PACIFIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2014
Last Update Date: 12/30/2022
Certification Date: 12/30/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

226 N KUAKINI ST
HONOLULU HI
96817-2488
US

IV. Provider business mailing address

2855 E MANOA RD STE 105 BOX #200
HONOLULU HI
96822-2488
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-3511
  • Fax: 808-535-1572
Mailing address:
  • Phone: 808-941-6300
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number
License Number State

VIII. Authorized Official

Name: KENT YAMAMOTO
Title or Position: MEMBER
Credential:
Phone: 808-941-6300