Healthcare Provider Details

I. General information

NPI: 1063519965
Provider Name (Legal Business Name): ALLEN STRASBERGER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/20/2006
Last Update Date: 02/14/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

46-001 KAMEHAMEHA HWY SUITE #412
KANEOHE HI
96744-3711
US

IV. Provider business mailing address

46-001 KAMEHAMEHA HWY SUITE #412
KANEOHE HI
96744-3711
US

V. Phone/Fax

Practice location:
  • Phone: 808-735-7681
  • Fax: 808-734-0027
Mailing address:
  • Phone: 808-735-7681
  • Fax: 808-734-0027

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208200000X
TaxonomyPlastic Surgery Physician
License Number5620
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: