Healthcare Provider Details

I. General information

NPI: 1548330632
Provider Name (Legal Business Name): NICHOLAS H. ZINA M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: HANNY NICO ZINA M.D.

II. Dates (important events)

Enumeration Date: 11/08/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3-3420 KUHIO HWY SUITE B
LIHUE HI
96766-1042
US

IV. Provider business mailing address

1946 YOUNG ST SUITE 360
HONOLULU HI
96826-2150
US

V. Phone/Fax

Practice location:
  • Phone: 808-245-1532
  • Fax: 808-632-2872
Mailing address:
  • Phone: 808-973-7320
  • Fax: 808-973-7325

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License NumberMD-7731
License Number StateHI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: