Healthcare Provider Details

I. General information

NPI: 1528574100
Provider Name (Legal Business Name): INSIGHT EEG LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/19/2017
Last Update Date: 12/19/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 S KING ST STE 218A
HONOLULU HI
96814-1703
US

IV. Provider business mailing address

PO BOX 31000 MAIL CODE 5765
HONOLULU HI
96849-0001
US

V. Phone/Fax

Practice location:
  • Phone: 808-593-9944
  • Fax: 808-593-9955
Mailing address:
  • Phone: 808-593-9944
  • Fax: 808-593-9955

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code293D00000X
TaxonomyPhysiological Laboratory
License Number
License Number State

VIII. Authorized Official

Name: ERIC HANNUM
Title or Position: OWNER
Credential:
Phone: 808-277-6816