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General NPI Number Information
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NPI Number | 1114258423
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Entity Type | Individual
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Provider Name | PEPE F TAETUNA LMT
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Gender | Female
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Dates
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Enumeration Date | 01/26/2010
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Last Update Date | 01/26/2010
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Provider Practice Location Address
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Address Line | 94-750 HIKIMOE ST STE C
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City | WAIPAHU
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State | HI
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Zip | 96797-3351
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Country | US
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Telephone | 808-671-4433
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Fax | 808-676-3006
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Provider Business Mailing Address
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Address Line | 91-1049 MIKOHU ST APT 11D
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City | EWA BEACH
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State | HI
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Zip | 96706-3817
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Country | US
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Telephone | 808-699-9023
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 507
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License Number State | HI
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