Healthcare Provider Details

I. General information

NPI: 1821758558
Provider Name (Legal Business Name): V2 MEDICAL GROUP LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/21/2021
Last Update Date: 12/21/2021
Certification Date: 12/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2490 KALAKAUA AVE 2ND FLOOR
HONOLULU HI
96815
US

IV. Provider business mailing address

758 KAPAHULU AVE STE 100-911
HONOLULU HI
96816-1196
US

V. Phone/Fax

Practice location:
  • Phone: 888-808-9909
  • Fax:
Mailing address:
  • Phone: 888-808-9909
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MR. CHRISTOPHER ROSENBAUM
Title or Position: CHIEF FINANCIAL OFFICER
Credential: MBA
Phone: 518-577-0964