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General NPI Number Information
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NPI Number | 1003522350
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Entity Type | Organization
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Legal Business Name | CARLY WACHI LLC
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Dates
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Enumeration Date | 01/30/2023
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Last Update Date | 01/30/2023
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Provider Practice Location Address
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Address Line | 4348 WAIALAE AVENUE # 788
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City | HONOLULU
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State | HI
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Zip | 96816-5767
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Country | US
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Telephone | 808-554-5470
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Fax |
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Provider Business Mailing Address
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Address Line | 4348 WAIALAE AVENUE # 788
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City | HONOLULU
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State | HI
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Zip | 96816-5767
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Country | US
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Telephone | 808-554-5470
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Fax |
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Authorized Official
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Title or Position | MEMBER
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Name | CARLY AKEMI WACHI
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Credential | M.D.
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Telephone | 808-554-5470
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number |
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License Number State |
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