Healthcare Provider Details

I. General information

NPI: 1689755704
Provider Name (Legal Business Name): PACIFIC PHYSICAL MEDICINE ASSOCIATES LLP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/17/2006
Last Update Date: 07/29/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 LUSITANA ST SUITE 805
HONOLULU HI
96813-2429
US

IV. Provider business mailing address

1380 LUSITANA ST SUITE 608
HONOLULU HI
96813-2421
US

V. Phone/Fax

Practice location:
  • Phone: 808-531-7277
  • Fax: 808-531-7207
Mailing address:
  • Phone: 808-531-7277
  • Fax: 808-531-7207

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: DR. DENNIS M CROWLEY
Title or Position: PARTNER
Credential: MD
Phone: 808-531-7277