Healthcare Provider Details

I. General information

NPI: 1003054578
Provider Name (Legal Business Name): HAWAII PACIFIC NEUROSCIENCE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/21/2009
Last Update Date: 10/19/2022
Certification Date: 10/19/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2230 LILIHA ST STE 104
HONOLULU HI
96817-7357
US

IV. Provider business mailing address

2230 LILIHA ST STE 104
HONOLULU HI
96817-7357
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-4476
  • Fax: 808-263-4476
Mailing address:
  • Phone: 808-261-4476
  • Fax: 808-263-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHELLE B LIOW
Title or Position: HEALTHCARE ADMINISTRATOR
Credential:
Phone: 808-261-4476