Healthcare Provider Details

I. General information

NPI: 1639327869
Provider Name (Legal Business Name): ADVANCED REPRODUCTIVE MEDICINE AND GYNECOLOGY OF HAWAII, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/29/2008
Last Update Date: 07/08/2024
Certification Date: 07/08/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1585 KAPIOLANI BLVD STE 1800
HONOLULU HI
96814-4500
US

IV. Provider business mailing address

1585 KAPIOLANI BLVD STE 1800
HONOLULU HI
96814-4500
US

V. Phone/Fax

Practice location:
  • Phone: 808-545-2800
  • Fax: 808-262-3744
Mailing address:
  • Phone: 808-545-2800
  • Fax: 808-262-3744

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QA0006X
TaxonomyAmbulatory Fertility Facility
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QM1300X
TaxonomyMulti-Specialty Clinic/Center
License NumberW9930065101
License Number StateHI

VIII. Authorized Official

Name: DENIS SALLE
Title or Position: BILLING MANAGER
Credential: MA., MBA
Phone: 808-255-9442