Healthcare Provider Details

I. General information

NPI: 1639278104
Provider Name (Legal Business Name): ALAN ABRAHAM BUFFENSTEIN M.D
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2006
Last Update Date: 02/01/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 WARD AVE #1070
HONOLULU HI
96814-1600
US

IV. Provider business mailing address

1100 WARD AVE #1070
HONOLULU HI
96814-1600
US

V. Phone/Fax

Practice location:
  • Phone: 808-548-5400
  • Fax: 808-548-5408
Mailing address:
  • Phone: 808-548-5400
  • Fax: 808-548-5408

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number5407
License Number StateHI
# 2
Primary TaxonomyN
Taxonomy Code2084P0805X
TaxonomyGeriatric Psychiatry Physician
License Number5407
License Number StateHI
# 3
Primary TaxonomyN
Taxonomy Code2084P2900X
TaxonomyPain Medicine (Psychiatry & Neurology) Physician
License Number5407
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: