Healthcare Provider Details

I. General information

NPI: 1467076125
Provider Name (Legal Business Name): SUMMER SAID DPT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/28/2020
Last Update Date: 05/28/2022
Certification Date: 05/28/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1029 KAPAHULU AVE #401
HONOLULU HI
96816-1332
US

IV. Provider business mailing address

801 SOUTH STREET #4705
HONOLULU HI
96813-5947
US

V. Phone/Fax

Practice location:
  • Phone: 808-739-1977
  • Fax: 808-739-1979
Mailing address:
  • Phone: 214-537-9859
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number1330958
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License NumberPT5136
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: