Healthcare Provider Details

I. General information

NPI: 1639341886
Provider Name (Legal Business Name): PHYSICIAN PROVIDERS, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/27/2008
Last Update Date: 03/27/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 ALA MOANA BLVD LOBBY LEVEL - ILIKAI HOTEL
HONOLULU HI
96815-1603
US

IV. Provider business mailing address

1777 ALA MOANA BLVD LOBBY LEVEL - ILIKAI HOTEL
HONOLULU HI
96815-1603
US

V. Phone/Fax

Practice location:
  • Phone: 808-926-9911
  • Fax: 808-949-7771
Mailing address:
  • Phone: 808-926-9911
  • Fax: 808-949-7771

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. JOHN RADY MAGAURAN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 808-926-9911