Healthcare Provider Details

I. General information

NPI: 1225329329
Provider Name (Legal Business Name): ALOHALANI MEDICAL SERVICES, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/22/2011
Last Update Date: 04/22/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2043 PUNA ST
HONOLULU HI
96817-1519
US

IV. Provider business mailing address

2043 PUNA ST
HONOLULU HI
96817-1519
US

V. Phone/Fax

Practice location:
  • Phone: 808-224-6587
  • Fax:
Mailing address:
  • Phone: 808-224-6587
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number
License Number State

VIII. Authorized Official

Name: DR. MARK Y LIU
Title or Position: CEO
Credential: D.O.
Phone: 808-224-6587