Healthcare Provider Details

I. General information

NPI: 1366445306
Provider Name (Legal Business Name): KORE K. LIOW MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/23/2005
Last Update Date: 09/10/2024
Certification Date: 09/10/2024
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: 808-551-6464
  • Fax: 808-263-4476

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License Number0428786
License Number StateKS
# 2
Primary TaxonomyY
Taxonomy Code2084N0400X
TaxonomyNeurology Physician
License NumberMD12149
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: