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General NPI Number Information
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NPI Number | 1164086336
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Entity Type | Individual
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Provider Name | ALLAN JAMES ABLAZA SAOIT APRN
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Gender | Male
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Dates
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Enumeration Date | 04/23/2019
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Last Update Date | 09/29/2026
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Provider Practice Location Address
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Address Line | 1245 KUALA ST STE 102A
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City | PEARL CITY
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State | HI
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Zip | 96782-3900
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Country | US
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Telephone | 808-627-2775
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Fax |
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Provider Business Mailing Address
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Address Line | 460 KAMAAHA AVE APT 32
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City | KAPOLEI
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State | HI
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Zip | 96707-4617
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Country | US
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Telephone | 808-627-2775
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5296
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License Number State | HI
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Taxonomy #2
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 87570
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License Number State | HI
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