Healthcare Provider Details

I. General information

NPI: 1760893382
Provider Name (Legal Business Name): MR. JAMES CS HUANG
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2014
Last Update Date: 05/16/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 NORTH PAUAHI STREET # 222
HONOLULU HI
90817
US

IV. Provider business mailing address

2542 DATE STREET APT # 1603
HONOLULU HI
96826
US

V. Phone/Fax

Practice location:
  • Phone: 808-277-8171
  • Fax:
Mailing address:
  • Phone: 808-277-8171
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMAT5518
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: