Healthcare Provider Details
I. General information
NPI: 1841705506
Provider Name (Legal Business Name): ERIN NAKATSUKA D.P.T.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 12/04/2017
Last Update Date: 12/06/2017
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
677 ALA MOANA BLVD STE 725
HONOLULU HI
96813-5417
US
IV. Provider business mailing address
1301 NAULU PL
HONOLULU HI
96818-1923
US
V. Phone/Fax
- Phone: 808-734-0010
- Fax: 808-734-0013
- Phone:
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2081S0010X |
| Taxonomy | Sports Medicine (Physical Medicine & Rehabilitation) Physician |
| License Number | PT-4507 |
| License Number State | HI |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: