Healthcare Provider Details

I. General information

NPI: 1689661969
Provider Name (Legal Business Name): PALI WOMENS HEALTH CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/03/2005
Last Update Date: 09/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

642 ULUKAHIKI ST. SUITE 642
KAILUA HI
96734
US

IV. Provider business mailing address

642 ULUKAHIKI ST SUITE 305
KAILUA HI
96734
US

V. Phone/Fax

Practice location:
  • Phone: 808-261-6644
  • Fax: 808-261-6645
Mailing address:
  • Phone: 808-261-6644
  • Fax: 808-261-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4609
License Number StateHI

VIII. Authorized Official

Name: DR. SUSAN H CHAPMAN
Title or Position: PRESIDENT
Credential: MD
Phone: 808-261-6644