Healthcare Provider Details

I. General information

NPI: 1174756662
Provider Name (Legal Business Name): ALOHA PAIN CLINIC, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 02/23/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

68-1845 WAIKOLOA RD STE 216
WAIKOLOA HI
96738-5584
US

IV. Provider business mailing address

PO BOX 7127
KAMUELA HI
96743-7127
US

V. Phone/Fax

Practice location:
  • Phone: 808-885-7246
  • Fax:
Mailing address:
  • Phone: 808-885-7246
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP3300X
TaxonomyPain Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. LYNN PUANA
Title or Position: OWNER
Credential: MD
Phone: 808-315-1922