Healthcare Provider Details

I. General information

NPI: 1346682549
Provider Name (Legal Business Name): ALL ACCESS ORTHO LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/29/2013
Last Update Date: 07/29/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1401 S BERETANIA ST SUITE 102
HONOLULU HI
96814-1870
US

IV. Provider business mailing address

1401 S BERETANIA ST SUITE 102
HONOLULU HI
96814-1870
US

V. Phone/Fax

Practice location:
  • Phone: 808-356-5699
  • Fax:
Mailing address:
  • Phone: 808-356-5699
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. GARY T BLUM
Title or Position: MEMBER
Credential: MD
Phone: 808-536-2261