Healthcare Provider Details

I. General information

NPI: 1134486814
Provider Name (Legal Business Name): GETTAFIX LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/18/2012
Last Update Date: 04/18/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

94-673 KUPUOHI ST SUITE# C201
WAIPAHU HI
96797-5367
US

IV. Provider business mailing address

590 PUUIKENA DR
HONOLULU HI
96821-2507
US

V. Phone/Fax

Practice location:
  • Phone: 808-387-8466
  • Fax: 808-373-3987
Mailing address:
  • Phone: 808-387-8466
  • Fax: 808-373-3987

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QU0200X
TaxonomyUrgent Care Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: PUGERA VINOO GANAPATHY
Title or Position: MANAGER/MEMBER
Credential: M.D.
Phone: 808-387-8466