Healthcare Provider Details

I. General information

NPI: 1053245100
Provider Name (Legal Business Name): MENTAL AND BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

770 KAPIOLANI BLVD STE 500
HONOLULU HI
96813-5258
US

IV. Provider business mailing address

770 KAPIOLANI BLVD STE 500
HONOLULU HI
96813-5258
US

V. Phone/Fax

Practice location:
  • Phone: 808-666-9960
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: DAVID SU
Title or Position: CEO
Credential:
Phone: 808-931-0717