Healthcare Provider Details

I. General information

NPI: 1477443869
Provider Name (Legal Business Name): SHAHD ZAAZA
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2025
Last Update Date: 07/07/2025
Certification Date: 07/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2500 CAMPUS RD
HONOLULU HI
96822-2217
US

IV. Provider business mailing address

2333 KAPIOLANI BLVD
HONOLULU HI
96826-4485
US

V. Phone/Fax

Practice location:
  • Phone: 808-956-8111
  • Fax:
Mailing address:
  • Phone: 818-469-6712
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2255A2300X
TaxonomyAthletic Trainer
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: