Healthcare Provider Details

I. General information

NPI: 1831358159
Provider Name (Legal Business Name): ALOHA UROLOGY, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/02/2008
Last Update Date: 10/20/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4722 AUKAI AVE
HONOLULU HI
96816-5207
US

IV. Provider business mailing address

1329 LUSITANA ST STE 506
HONOLULU HI
96813-2412
US

V. Phone/Fax

Practice location:
  • Phone: 808-737-9387
  • Fax:
Mailing address:
  • Phone: 808-599-7779
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208800000X
TaxonomyUrology Physician
License NumberMD-11120
License Number StateHI

VIII. Authorized Official

Name: DR. GARRY B PEERS
Title or Position: PRESIDENT
Credential:
Phone: 808-599-7779