Healthcare Provider Details

I. General information

NPI: 1619085859
Provider Name (Legal Business Name): CHART REHABILITATION OF HAWAII INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2006
Last Update Date: 05/11/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-810 MOLOALO ST 220
WAIPAHU HI
96797-3355
US

IV. Provider business mailing address

826 S KING ST
HONOLULU HI
96813-3009
US

V. Phone/Fax

Practice location:
  • Phone: 808-671-1711
  • Fax: 808-671-1705
Mailing address:
  • Phone: 808-523-9043
  • Fax: 808-526-0673

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name: MR. KEVIN MICHAEL TAKAKI
Title or Position: VICE PRESIDENT ADMINISTRATION
Credential:
Phone: 808-523-9043