Healthcare Provider Details

I. General information

NPI: 1699106518
Provider Name (Legal Business Name): MS. ANAHITA SHEIKH-OL-ESLAMI
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/03/2013
Last Update Date: 12/07/2023
Certification Date: 12/05/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-2166 SOUTH POINT RD
NAALEHU HI
96772-9677
US

IV. Provider business mailing address

PO BOX 1059
NAALEHU HI
96772-1059
US

V. Phone/Fax

Practice location:
  • Phone: 808-557-7260
  • Fax:
Mailing address:
  • Phone: 808-557-7260
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code171100000X
TaxonomyAcupuncturist
License Number15351
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: